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MR. CLINT M. COSTANZA ,PA
NPI 1619266954
Physician Assistant - Surgical in Baton Rouge, LA

Active since April 06, 2011PECOS Enrolled
9001 SUMMA AVE, BATON ROUGE, LA 70809(225) 761-5200(225) 761-5702 Get Directions Write a Review

NPPES record last updated: April 9, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Clint M. Costanza ,pa NPPES

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

MR. CLINT M. COSTANZA ,PA (NPI 1619266954) is an individual surgical provider in Baton Rouge, Louisiana, licensed in Louisiana (PA.200436) and active in the NPI registry since April 2011. He is enrolled in Medicare PECOS and is a graduate of Other (2010).

NPPES Registry Identity

NPI1619266954
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameMR. CLINT M. COSTANZACredential: ,PA
Location Address9001 SUMMA AVEBaton Rouge, LA 70809-3726
Mailing Address9001 Summa AveBaton Rouge, LA 70809-3726 · (225) 761-5200 · Fax (225) 761-5702
Phone(225) 761-5200
Fax(225) 761-5702
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateApril 6, 2011
Last NPPES UpdateApril 9, 2013
✔ NPI 1619266954 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in LA · PA.200436
9001 SUMMA AVE, Baton Rouge, LA 70809
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Other Identifiers 3

Medicaid2141252LA
Medicare PIN56629PE62LA
Medicaid07908012MS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, HMO Louisiana, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Clint M. Costanza ,pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5698950871
PECOS Enrollment IDI20110503000845
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.

Other Providers at the Same Location NPPES 20

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

DR. THOMAS R FAIRLEY O.D.
Optometrist
9001 SUMMA AVE
BATON ROUGE, LA 70809
East Baton Rouge Parish (225) 761-5200
KAYLA DAWN SLIMAN M.D.
Internal Medicine (Gastroenterology)
9001 SUMMA AVE
BATON ROUGE, LA 70809
East Baton Rouge Parish (225) 761-5219
ABDUL BASET KHAN MD
Psychiatry & Neurology (Neurology)
9001 SUMMA AVE
BATON ROUGE, LA 70809
East Baton Rouge Parish (225) 761-5200
DIONNA MICHELLE MATHEWS M.D.
Pediatrics
9001 SUMMA AVE
BATON ROUGE, LA 70809
East Baton Rouge Parish (225) 761-5405
MS. MOLLY ELIZABETH MCRAE RN PRACTITIONER
Nurse Practitioner
9001 SUMMA AVE
BATON ROUGE, LA 70809
East Baton Rouge Parish (225) 761-5200
WILLIAM FREDERICK WATERS PH.D
Psychologist (Clinical)
9001 SUMMA AVE
BATON ROUGE, LA 70809
East Baton Rouge Parish (225) 761-5200
GIA TYSON LANDRY M.D.
Internal Medicine (Gastroenterology)
9001 SUMMA AVE
BATON ROUGE, LA 70809
East Baton Rouge Parish (225) 761-5219
ELIZABETH BREAUX MCELVEEN RNFA
Registered Nurse
9001 SUMMA AVE
BATON ROUGE, LA 70809
East Baton Rouge Parish (225) 761-5479

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 Clint Costanza's NPI number?

The NPI number for Clint Costanza is 1619266954. It was assigned to this individual provider in the NPPES registry on April 6, 2011.

Where is Clint Costanza located?

Clint Costanza practices at 9001 Summa Ave, Baton Rouge, LA 70809. The listed phone number is (225) 761-5200.

What is Clint Costanza's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Clint Costanza enrolled in Medicare?

Yes. Clint Costanza is registered in the Medicare PECOS enrollment system.

What insurance does Clint Costanza accept?

Health plans from Blue Cross and Blue Shield of Louisiana, HMO Louisiana and UnitedHealthcare list Clint Costanza 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.

When was this NPI record last updated?

The NPPES record for Clint Costanza was last updated on April 9, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.