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Joseph Costa, OD

Optometry · San Jose

NPI 1558429464

Medicare standing
Clear
Enrolled, allowed to bill and order, not excluded
Plans that list them
5
1 carrier
Office
1

Offices

1 location

Looking this up.

Plans that list them

5 plans · 1 carrier

A missing listing does not mean out of network. Directories change, and a listing does not cover every office. Call Dr. Costa’s office at (408) 258-7512 to confirm they take your plan. Ask about the office you use, its medical group, referrals and appointments.

Plans whose provider directory lists this clinician
Central Health Classic Care Plan III (HMO)Central Health Medicare PlanListedAug 15, 2026
Central Health Dual Access Plan (HMO D-SNP)Central Health Medicare PlanListedAug 15, 2026
Central Health Embrace Care Plan (HMO C-SNP)Central Health Medicare PlanListed, may be out of dateSep 15, 2025
Central Health Embrace Choice Plan (HMO C-SNP)Central Health Medicare PlanListedAug 15, 2026
Central Health Valor Care Plan (HMO)Central Health Medicare PlanListedAug 15, 2026

Original Medicare doctor bills

$1,643

Medicare paid this office $1,643 for 16 people.

This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.

Largest Original Medicare bills
Established patient complete exam of visual system13$1,301$81

Who their Medicare patients are

16 Original Medicare patients in 2024. Average age 76 · Under 65 0% · Also on Medicaid 0% · Health risk score 0.63. At or below the middle of the specialty; the typical optometry clinician is at 0.97.

Conditions among them: High blood pressure 75%.

The office billed $2,475, Medicare allowed $2,441 and paid $1,643; for 19 services of 2 kinds.

Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.

Year by year

Original Medicare by year
20241619760.63$2,475$1,643
20221616730.72$2,325$1,377
20212526750.84$3,475$2,370
20202626751.35$3,625$1,987
20192525741.07$3,725$2,557
20185759761.46$8,700$5,970
20175556761.37$8,400$5,928
20165354731.56$8,075$5,272
20156569751.01$9,045$6,012
20146976751.34$8,380$5,996
20137680741.36$8,910$5,993

Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.

See the services billed each year

2022: 1 service

Original Medicare services billed in 2022
Established patient complete exam of visual system13$1,140$88

2021: 1 service

Original Medicare services billed in 2021
Established patient complete exam of visual system17$1,566$87

2020: 1 service

Original Medicare services billed in 2020
Established patient complete exam of visual system15$1,208$81

2019: 1 service

Original Medicare services billed in 2019
Established patient complete exam of visual system14$1,529$109

2018: 2 services

Original Medicare services billed in 2018
Established patient complete exam of visual system35$3,753$104
New patient complete exam of visual system19$1,891$100

2017: 1 service

Original Medicare services billed in 2017
Established patient complete exam of visual system45$4,890$106

2016: 2 services

Original Medicare services billed in 2016
Established patient complete exam of visual system37$3,546$96
New patient complete exam of visual system16$1,646$103

2015: 2 services

Original Medicare services billed in 2015
Established patient complete exam of visual system46$4,126$84
New patient complete exam of visual system17$1,639$96

2014: 2 services

Original Medicare services billed in 2014
Established patient complete exam of visual system55$4,521$77
New patient complete exam of visual system17$1,475$87

2013: 2 services

Original Medicare services billed in 2013
Established patient complete exam of visual system55$4,082$70
New patient complete exam of visual system21$1,837$87

Medicaid work

$3,062 in 2024

Medicaid paid $3,062 for 737 billed services this clinician did in 2024, up to 32 people in a month for one service.

Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.

Largest Medicaid services in 2024
OPH SVCS MEDICAL XM&EVAL COMPRE NEW PT 1/> VST148$1,065
Frames, purchases228$921
Fitting of monofocal spectacles74$388
DETERMINATION REFRACTIVE STATE221$353
Fitting of bifocal spectacles53$229
OPH SVCS MEDICAL XM&EVAL COMPRE EST PT 1/>VST13$107
Medicaid work by year
2024737632$3,062
2023520526$2,131
2022479537$1,671
2021576624$3,673
2020424524$1,848
2019195520$950
2018365521$1,477
See the largest Medicaid services in earlier years

2023

Largest Medicaid services in 2023
Frames, purchases195$710
Fitting of monofocal spectacles95$387
DETERMINATION REFRACTIVE STATE153$380
OPH SVCS MEDICAL XM&EVAL COMPRE NEW PT 1/> VST51$334
OPH SVCS MEDICAL XM&EVAL COMPRE EST PT 1/>VST26$320

2022

Largest Medicaid services in 2022
OPH SVCS MEDICAL XM&EVAL COMPRE EST PT 1/>VST38$533
Frames, purchases144$499
DETERMINATION REFRACTIVE STATE164$252
OPH SVCS MEDICAL XM&EVAL COMPRE NEW PT 1/> VST66$213
Fitting of monofocal spectacles67$175

2021

Largest Medicaid services in 2021
Frames, purchases180$1,467
OPH SVCS MEDICAL XM&EVAL COMPRE NEW PT 1/> VST54$781
Fitting of monofocal spectacles126$729
DETERMINATION REFRACTIVE STATE190$447
Fitting of bifocal spectacles13$143
OPH SVCS MEDICAL XM&EVAL COMPRE EST PT 1/>VST13$107

2020

Largest Medicaid services in 2020
Frames, purchases115$599
Fitting of monofocal spectacles120$465
OPH SVCS MEDICAL XM&EVAL COMPRE NEW PT 1/> VST38$355
DETERMINATION REFRACTIVE STATE124$216
OPH SVCS MEDICAL XM&EVAL COMPRE EST PT 1/>VST27$213

2019

Largest Medicaid services in 2019
OPH SVCS MEDICAL XM&EVAL COMPRE EST PT 1/>VST26$355
DETERMINATION REFRACTIVE STATE132$288
Frames, purchases12$158
Fitting of monofocal spectacles13$78
OPH SVCS MEDICAL XM&EVAL COMPRE NEW PT 1/> VST12$71

2018

Largest Medicaid services in 2018
OPH SVCS MEDICAL XM&EVAL COMPRE NEW PT 1/> VST81$553
DETERMINATION REFRACTIVE STATE187$404
OPH SVCS MEDICAL XM&EVAL COMPRE EST PT 1/>VST25$218
Fitting of monofocal spectacles55$155
Frames, purchases17$147

Money from drug and device companies

$197 in 2024

A payment is not proof that care is biased.

Payments by company
CooperVisionNone$197
1 payment
  • Debt forgiveness · 2024-08-01 · $197
See the published payment
Every published payment
CooperVisionDebt forgiveness · 2024-08-01None$197

Professional record

NPI
1558429464
Licence
CA 8952T
Trained
University of California - School of Optometry, 1988
Gender
Male
More record details
Sole proprietor
Yes
Medicaid ID
CA SD0089521
Taxonomy
Federal specialty code 152W00000X (152W00000X)
Mailing address
4600 Alum Rock Ave Ste 4, San Jose, CA, 95127
NPI first listed
2006-12-04
NPI last updated
2007-07-08

This is when the NPI record was last certified, not a medical board exam.