MRS. LETY ELIZABETH COSTA MD
NPI 1821188269
Internal Medicine in Dos Palos, CA

Q: What is Lety Costa's NPI number?

The NPI number for Lety Costa is 1821188269. It was assigned to this individual provider in the NPPES registry on October 14, 2006. The provider is also known as Lety Elizabeth Amaya.

Q: What is Lety Costa's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Lety Costa was last updated on August 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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 October 14, 2006PECOS Enrolled

1405 CALIFORNIA AVE, DOS PALOS, CA 93620(209) 722-4842 Get Directions Write a Review

NPPES record last updated: August 1, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 15, 2022, Aug 14, 2022, Aug 5, 2022 and 3 more (6 updates tracked since 2018).

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About Mrs. Lety Elizabeth Costa Md NPPES

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

MRS. LETY ELIZABETH COSTA MD (NPI 1821188269) is an individual internal medicine provider in Dos Palos, California, licensed in California (A187054) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Gordon.

NPPES Registry Identity

NPI1821188269

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameMRS. LETY ELIZABETH COSTACredential: MD

Location Address1405 CALIFORNIA AVEDos Palos, CA 93620-2300

Mailing Address749 Eggleston AveDos Palos, CA 93620-9564 · (208) 282-0196 · Fax (855) 202-9336

Phone(209) 722-4842

Sole ProprietorNo

Enumeration DateOctober 14, 2006

Last NPPES UpdateAugust 1, 20256 updates tracked since enumeration

NPPES CertifiedAugust 1, 2025

✔ NPI 1821188269 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in CA · A187054

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedFamily MedicineTaxonomy 207Q00000X · License ME158393 (FL)

Also ListedPhysician AssistantTaxonomy 363A00000X · License PA17517 (CA), 680 (NE)

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 110879 (NE)

1405 CALIFORNIA AVE, Dos Palos, CA 93620

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Other Names 1

Former Name (1)Lety Elizabeth Amaya

Secondary Practice Location 1

Location 1807 North AshGordon, NE 69343-1132 · Phone (308) 282-2200 · Fax (308) 282-1428

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Lety Elizabeth Costa Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Lety Costa reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Golden Valley Health Center

Same address

Federally Qualified Health Center (FQHC)

1405 CALIFORNIA AVE
Dos Palos, CA 93620

Reassigned Medicare billing, California enrollment
Medicare enrollment name: Golden Valley Health Centers
440 clinicians in this Medicare group

NPI 1770567778 (209) 392-2111

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 93620 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

$133.94 typical visit price

range $58.87 – $176.60

Typical copayment $33.48 (range $14.71 – $44.15)

Most-billed visit code 99204

Established Patient

$103.36 typical visit price

range $19.28 – $144.60

Typical copayment $25.84 (range $4.82 – $36.15)

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 8

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

ANDREA LESA VELASQUEZ FNP

Nurse Practitioner (Family)