DR. THEODORE A DACOSTA JR. MD
NPI 1558395673
Internal Medicine - Gastroenterology in Orange, NJ

Q: What is Theodore Dacosta's NPI number?

The NPI number for Theodore Dacosta is 1558395673. It was assigned to this individual provider in the NPPES registry on July 11, 2006.

Q: What is Theodore Dacosta's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Theodore Dacosta was last updated on September 11, 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 July 11, 2006PECOS EnrolledAccepts Medicare Assignment

85 S JEFFERSON STREET, ORANGE, NJ 07050(973) 674-8866(973) 672-9299 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Theodore A Dacosta Jr. Md NPPES

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

DR. THEODORE A DACOSTA JR. MD (NPI 1558395673) is an individual gastroenterology provider in Orange, New Jersey, licensed in New Jersey (25MA05600200) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Clara Maass Medical Center, and is a graduate of Rutgers New Jersey Medical School (1989).

NPPES Registry Identity

NPI1558395673

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameDR. THEODORE A DACOSTA JR.Credential: MD

Location Address85 S JEFFERSON STREETOrange, NJ 07050

Mailing Address85 S Jefferson StreetOrange, NJ 07050 · (973) 674-8866 · Fax (973) 672-9299

Phone(973) 674-8866

Fax(973) 672-9299

Sole ProprietorNo

Medical School CMSRutgers New Jersey Medical SchoolGraduated 1989

Enumeration DateJuly 11, 2006

Last NPPES UpdateSeptember 11, 2025

✔ NPI 1558395673 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in NJ · 25MA05600200

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Also ListedInternal MedicineTaxonomy 207R00000X · License 25MA05600200 (NJ)

85 S JEFFERSON STREET, Orange, NJ 07050

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Other Identifiers 1

Medicaid6881106NJ

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Theodore A Dacosta Jr. 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 ID9931144821

PECOS Enrollment IDI20050622000030

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.

Medicare Billing Reassignments

Medicare enrollment records show Theodore Dacosta reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Dacosta Medical Group LLC

0.3 mi

Gastroenterology

85 S JEFFERSON STREET
Orange, NJ 07050

Reassigned Medicare billing, New Jersey enrollment
2 clinicians in this Medicare group

NPI 1346461282 (973) 674-8866

Central Avenue Professional Services, PC

4.0 mi

Critical Care Medicine

111 CENTRAL AVE
Newark, NJ 07102

Reassigned Medicare billing, New Jersey enrollment
112 clinicians in this Medicare group

NPI 1447649694 (973) 877-5300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 12

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 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.

139 services87 patients

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.

105 services69 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

61 services40 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

31 services30 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

31 services31 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

23 services23 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

22 services22 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

14 services14 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

14 services13 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

12 services12 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

12 services12 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Clara Maass Medical Center

Acute Care Hospitals · Belleville, NJ

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310009

LocationOne Clara Maass DriveBelleville, NJ 07109 · Essex County

Emergency services Birthing friendly

Saint Michael's Medical Center

Acute Care Hospitals · Newark, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310096

Location111 Central AvenueNewark, NJ 07102 · Essex County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07050 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

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$12.06 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$52.06 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

DACOSTA MEDICAL GROUP LLC

Internal Medicine (Gastroenterology)

85 S JEFFERSON STREET
ORANGE, NJ 07050

Essex County (973) 674-8866

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 Theodore Dacosta's NPI number?

The NPI number for Theodore Dacosta is 1558395673. It was assigned to this individual provider in the NPPES registry on July 11, 2006.

Where is Theodore Dacosta located?

Theodore Dacosta practices at 85 S Jefferson Street, Orange, NJ 07050. The listed phone number is (973) 674-8866.

What is Theodore Dacosta's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Theodore Dacosta enrolled in Medicare?

Yes. Theodore 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.

Which organizations bill Medicare for Theodore Dacosta's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Theodore Dacosta reassigns Medicare benefits to 2 organizations: Dacosta Medical Group LLC (Orange, NJ) and Central Avenue Professional Services, PC (Newark, NJ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Theodore Dacosta's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Theodore Dacosta accept?

Health plans from Oscar Health list Theodore 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 Theodore Dacosta affiliated with any hospitals?

According to CMS data, Theodore Dacosta is affiliated with Clara Maass Medical Center and Saint Michael's Medical Center.

When was this NPI record last updated?

The NPPES record for Theodore Dacosta was last updated on September 11, 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.