Individual provider Active NPI

Alexandra Deanne Costlow, AUD

  • Audiologist-Hearing Aid Fitter
  • Philadelphia, PA
National Provider Identifier
1043640592
Registry record updated May 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
AT006318 Issued in PA
Practice address
925 Chestnut Street
6TH Floor
Philadelphia, PA 19107-4201
Phone
(215) 955-6760
Fax
(215) 503-3736
NPI assigned
Nov 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X AT006318 PA Primary

Addresses

Primary practice location

925 Chestnut Street
6TH Floor
Philadelphia, PA 19107-4201

Mailing address

925 Chestnut Street
6TH Floor
Philadelphia, PA 19107-4201
Phone (215) 955-6760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140401000423 PA Practitioner - Qualified Audiologist 2163653395 Reassigns benefits to 1 organization
I20200527000472 NJ Practitioner - Qualified Audiologist 2163653395 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AT006318PAMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Feb 25, 2014 Accepting new patients
Jefferson University Physicians of New Jersey, P.C. CurrentSince Apr 1, 2020 Accepting new patients

Locations

2211 Chapel Ave W
Ste 403
Cherry Hill, NJ 08002
Phone (856) 922-5030

443 Laurel Oak Rd
Ste 130
Voorhees, NJ 08043
Phone (856) 741-0122

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1384905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1043640592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT STREET",
            "address_2": "6TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074201",
            "telephone_number": "215-955-6760",
            "fax_number": "215-503-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT STREET",
            "address_2": "6TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074201",
            "telephone_number": "215-955-6760",
            "fax_number": "215-503-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTLOW",
        "first_name": "ALEXANDRA",
        "middle_name": "DEANNE",
        "name_prefix": "Ms.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-20",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "PA",
            "license": "AT006318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.