DR. DARY JONATHAN COSTA (MD) – Otolaryngology Physician, NPI 1184826273
Otolaryngology Physician
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. DARY JONATHAN COSTA (MD)
PO BOX 776879
CHICAGO, IL 606776879
Phone: (502) 588-9490
Fax: (502) 272-5116
Type: Mailing
411 E CHESTNUT ST # LEVEL6
LOUISVILLE, KY 402021713
Phone: (502) 588-9587
Fax: (502) 588-9580
Type: Location
660, South Euclid Avenue, Central West End, City of Saint Louis, Missouri, 63110, United States
C B 8115
SAINT LOUIS, MO 631101010
Phone: (314) 454-6162
Fax: (314) 454-2174
Type: Mailing
Saint Louis Childrens Hospital School, 1, Children's Place, Central West End, City of Saint Louis, Missouri, 63110, United States
THIRD FLOOR
SAINT LOUIS, MO 631101002
Phone: (314) 454-6162
Fax: (314) 454-2174
Type: Location
1008 S SPRING AVE # 3300
SAINT LOUIS, MO 631102520
Phone: (314) 977-8884
Type: Mailing
1465 S GRAND BLVD
SAINT LOUIS, MO 631041003
Phone: (314) 268-4010
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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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: 2021-03-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20110818000105 | I | Otolaryngology | MO | TBD |
| I20210301001407 | I | Otolaryngology | IL | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60677)
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