Individual provider Active NPI

James S Costlow, MD

  • Internal Medicine Physician
  • Monroeville, PA
National Provider Identifier
1043228059
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD022329E Issued in PA
Practice address
3824 Northern Pike
Ste 200
Monroeville, PA 15146-2141
Phone
(412) 380-2800
Fax
(412) 380-2812
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD022329E PA Primary

Addresses

Primary practice location

3824 Northern Pike
Ste 200
Monroeville, PA 15146-2141

Mailing address

3824 Northern Pike
Ste 700
Monroeville, PA 15146-2141
Phone (412) 457-0060

Other identifiers 6

IdentifierTypeStateIssuer
P000750OtherGATEWAY HEALTH PLAN
102259OtherUPMC HEALTH PLAN
110079450OtherRAILROAD MEDICARE
4077096OtherAETNA
000788563MedicaidPA
063157OtherBLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jamescostlow@pmapa.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD022329EPAMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1043228059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3824 NORTHERN PIKE",
            "address_2": "STE 700",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462141",
            "telephone_number": "412-457-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3824 NORTHERN PIKE",
            "address_2": "STE 200",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462141",
            "telephone_number": "412-380-2800",
            "fax_number": "412-380-2812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTLOW",
        "first_name": "JAMES",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD022329E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "P000750",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC HEALTH PLAN",
            "identifier": "102259",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110079450",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4077096",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000788563",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "063157",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jamescostlow@pmapa.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1916 Lincoln Hwy",
            "city": "North Versailles",
            "state": "PA",
            "country_code": "US",
            "postal_code": "151372706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.