DR. THEODORE A JR. DACOSTA (MD) – Gastroenterology Physician, NPI 1558395673
Gastroenterology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
757 GASTROENTEROLOGY in NJ
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Provider Addresses for DR. THEODORE A JR. DACOSTA (MD)
85, South Jefferson Street, Orange, Essex County, New Jersey, 07050, United States
ORANGE, NJ 07050
Phone: (973) 674-8866
Fax: (973) 672-9299
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $52.
Total Amount is formed as General ($52) + Research ($0) + Ownership ($0) = $52.
Last reported payment date: 2024-02-08 • Largest payer in this snapshot: Boston Scientific Corporation ($35).
Total Amount
$52
General + Research + Ownership
Payments
2
Total payment records
General Amount
$52
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $35 |
| ABBVIE INC. | $17 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-06-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050622000030 | I | Gastroenterology | NJ | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 166 | 96 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 135 | 79 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 46 | 35 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 22 | 22 | $0 |
| 43239 | Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 22 | 22 | $0 |
Insurance plans in this area (ZIP 07050)
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Provider's Procedures
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