JACK M. COSTA, M.D., P.C.
NPI 1972808335
Specialist in Fairfax, VA

Q: What is Jack M. Costa, M.D., P.C.'s NPI number?

The NPI number for Jack M. Costa, M.D., P.C. is 1972808335. It was assigned to this organization in the NPPES registry on January 17, 2011.

Q: What is Jack M. Costa, M.D., P.C.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since January 17, 2011

3650 JOSEPH SIEWICK DR, SUITE 202, FAIRFAX, VA 22033(703) 391-2516(703) 476-8244 Get Directions Write a Review

NPPES record last updated: January 17, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jack M. Costa, M.d., P.c. NPPES

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

JACK M. COSTA, M.D., P.C. (NPI 1972808335) is a healthcare organization registered as a specialist in Fairfax, Virginia and active in the NPI registry since January 2011. The organization lists Jack M. Costa, Owner, as its authorized official.

NPPES Registry Identity

NPI1972808335

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameJACK M. COSTA, M.D., P.C.

Location Address3650 JOSEPH SIEWICK DR, SUITE 202Fairfax, VA 22033-1710

Mailing Address3650 Joseph Siewick Dr, Suite 202Fairfax, VA 22033-1710 · (703) 391-2516 · Fax (703) 476-8244

Phone(703) 391-2516

Fax(703) 476-8244

Organization SubpartNo

Authorized OfficialJack M. CostaOwner · (703) 391-2516

Enumeration DateJanuary 17, 2011

✔ NPI 1972808335 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in VA · 0101028288

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

3650 JOSEPH SIEWICK DR, Fairfax, VA 22033

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Other Identifiers 4

Medicare UPINC62572

Other003539VA · Anthem

Medicare PIN409274

Other9320VA · Blue Cross Blue Shield

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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.

THUY PHUONG THI VO M.D.

Family Medicine

3650 JOSEPH SIEWICK DR, 400
FAIRFAX, VA 22033

Fairfax County (703) 391-2020

KATHERINE BOOKER PT

Physical Therapist

3650 JOSEPH SIEWICK DR, SUITE 308
FAIRFAX, VA 22033

Fairfax County (703) 716-4794

DR. LAURA E. BYRNES M.D.

Pediatrics

3650 JOSEPH SIEWICK DR, STE 101
FAIRFAX, VA 22033

Fairfax County (703) 391-0900

DR. HEON SOO YI M.D.

Family Medicine

3650 JOSEPH SIEWICK DR, SUITE 400
FAIRFAX, VA 22033

Fairfax County (703) 391-2020

VICTORIA LESSINGER MERKEL MD

Family Medicine

3650 JOSEPH SIEWICK DR, STE 400
FAIRFAX, VA 22033

Fairfax County (703) 391-2020

BRENT R AIN MD

Orthopaedic Surgery

3650 JOSEPH SIEWICK DR, SUITE 300
FAIRFAX, VA 22033

Fairfax County (703) 391-0111

SANDY L. CHUNG M.D.

Pediatrics

3650 JOSEPH SIEWICK DR, STE 101
FAIRFAX, VA 22033

Fairfax County (703) 391-0900

DR. PETER STEPHEN ROSS MD

Internal Medicine (Endocrinology, Diabetes & Metabolism)

3650 JOSEPH SIEWICK DR, #305
FAIRFAX, VA 22033

Fairfax County (703) 648-1831

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 Jack M. Costa, M.D., P.C.'s NPI number?

The NPI number for Jack M. Costa, M.D., P.C. is 1972808335. It was assigned to this organization in the NPPES registry on January 17, 2011.

Where is Jack M. Costa, M.D., P.C. located?

Jack M. Costa, M.D., P.C. is located at 3650 Joseph Siewick Dr Suite 202, Fairfax, VA 22033. The listed phone number is (703) 391-2516.

What is Jack M. Costa, M.D., P.C.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Jack M. Costa, M.D., P.C. was last updated on January 17, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.