MARY DACOSTA MD
NPI 1255919965
Family Medicine in Alice, TX

Q: What is Mary Dacosta's NPI number?

The NPI number for Mary Dacosta is 1255919965. It was assigned to this individual provider in the NPPES registry on April 1, 2021.

Q: What is Mary Dacosta's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Dacosta was last updated on July 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 01, 2021PECOS EnrolledAccepts Medicare Assignment

2510 E MAIN ST STE 102, ALICE, TX 78332(361) 664-4445 Get Directions Write a Review

NPPES record last updated: July 14, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 8, 2024, Apr 3, 2021 (2 updates tracked since 2021).

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About Mary Dacosta Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY DACOSTA MD (NPI 1255919965) is an individual family medicine provider in Alice, Texas, licensed in Texas (V2049) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS, is affiliated with Sanford Worthington Medical Center, and maintains a secondary practice location in Arlington.

NPPES Registry Identity

NPI1255919965

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameMARY DACOSTACredential: MD

Location Address2510 E MAIN ST STE 102Alice, TX 78332-4188

Mailing Address3301 Matlock RdArlington, TX 76015-2908 · (682) 509-6200

Phone(361) 664-4445

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateApril 1, 2021

Last NPPES UpdateJuly 14, 20252 updates tracked since enumeration

NPPES CertifiedJuly 14, 2025

✔ NPI 1255919965 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in TX · V2049✔ Licensed in MN · 79645

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2510 E MAIN ST STE 102, Alice, TX 78332

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Secondary Practice Location 1

Location 13301 Matlock RdArlington, TX 76015-2908 · Phone (682) 509-6200

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mary Dacosta Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638573264

PECOS Enrollment IDI20250815004151

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

44 services32 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

22 services20 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Sanford Worthington Medical Center

Acute Care Hospitals · Worthington, MN

OwnershipVoluntary non-profit - Private

CMS Certification Number240022

Location1018 Sixth Avenue PO Box 997Worthington, MN 56187 · Nobles County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78332 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTIN LENI DILLON NP-C

Nurse Practitioner (Family)

2510 E MAIN ST STE 102
ALICE, TX 78332

Jim Wells County (361) 664-4445

RICARDO J REQUENEZ NP

Nurse Practitioner (Family)

2510 E MAIN ST STE 102
ALICE, TX 78332

Jim Wells County (361) 664-4445

ASHLEY ANNA BOERJAN NP

Nurse Practitioner (Family)

2510 E MAIN ST STE 102
ALICE, TX 78332

Jim Wells County (361) 664-4445

BRITTANY KLEPAC KUBENA PA-C

Physician Assistant

2510 E MAIN ST STE 102
ALICE, TX 78332

Jim Wells County (361) 664-4445

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Dacosta's NPI number?

The NPI number for Mary Dacosta is 1255919965. It was assigned to this individual provider in the NPPES registry on April 1, 2021.

Where is Mary Dacosta located?

Mary Dacosta practices at 2510 E Main St Ste 102, Alice, TX 78332. The listed phone number is (361) 664-4445.

What is Mary Dacosta's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Mary Dacosta enrolled in Medicare?

Yes. Mary Dacosta is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mary Dacosta accept?

Health plans from Sanford Health Plan list Mary Dacosta as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mary Dacosta affiliated with any hospitals?

According to CMS data, Mary Dacosta is affiliated with Sanford Worthington Medical Center.

When was this NPI record last updated?

The NPPES record for Mary Dacosta was last updated on July 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.