NPIMap

Individual provider Active NPI

Michelle Marie Dicostanzo, MD

  • Family Medicine Physician
  • Corydon, IN
National Provider Identifier
1053764936
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01082458A Issued in IN
Practice address
1263 Hospital Dr NW Ste 280
Corydon, IN 47112-2174
Phone
(812) 738-3086
Fax
(812) 738-1865
NPI assigned
Jul 15, 2016
Last updated
Apr 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01082458A IN Primary
Family Medicine Physician 207Q00000X R-10580 IA

Addresses

Primary practice location

1263 Hospital Dr NW Ste 280
Corydon, IN 47112-2174

Mailing address

1263 Hospital Dr NW Ste 280
Corydon, IN 47112-2174
Phone (812) 738-3086

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190727000249 IN Practitioner - Family Practice 7810281540 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harrison County HospitalGroup PAC ID 9032007208, 45 clinicians

Practice addresses (Care Compare)

1263 Hospital Dr NW
Suite 280
Corydon, IN 47112-2174
Phone (812) 738-3086

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-10580IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Villagemd Indiana, PC Family Medicine CurrentSince Mar 28, 2022 Accepting new patients
Harrison County Hospital CurrentSince Aug 1, 2024 Accepting new patients
Porter Physician Services LLC Family Medicine CurrentSince Sep 1, 2019 Accepting new patients
Harrison County Hospital CurrentSince Aug 1, 2024 Accepting new patients
Harrison County Hospital Current Accepting new patients
Northwest Indiana Nephrology PC Past Accepting new patients
Harrison County Hospital Family Medicine Past Accepting new patients
Harrison County Hospital Family Medicine Past Accepting new patients

Locations

2022 Kelle Dr
Chesterton, IN 46304
Phone (219) 364-3616

650 Dickinson Rd
Ste Z
Chesterton, IN 46304
Phone (219) 464-9507

1141 Hospital Dr NW
Corydon, IN 47112
Phone (812) 738-7830

1263 Hospital Dr NW
Ste 280
Corydon, IN 47112
Phone (812) 738-3086

7890 E Ridge Rd
Hobart, IN 46342
Phone (219) 788-1237

6097 Broadway
Merrillville, IN 46410
Phone (219) 758-5152

5995 US Highway 6
Portage, IN 46368
Phone (219) 762-2134

Organizations & group practices 8

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1053764936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1263 HOSPITAL DR NW STE 280",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471122174",
            "telephone_number": "812-738-3086",
            "fax_number": "812-738-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1263 HOSPITAL DR NW STE 280",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471122174",
            "telephone_number": "812-738-3086",
            "fax_number": "812-738-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICOSTANZO",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-15",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01082458A",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R-10580",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corydon, IN

Sources for this page

Verify at the official NPI Registry.