Individual provider Active NPI

Thomas E Costello, M.D.

  • Family Medicine Physician
  • Melville, NY
National Provider Identifier
1093957342
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
267336 Issued in NY
Practice address
150 Broadhollow Rd Ste 120
Melville, NY 11747-4901
Phone
(631) 450-1400
NPI assigned
Apr 1, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 011915 NY
Family Medicine Physician 207Q00000X 267336 NY Primary

Addresses

Primary practice location

150 Broadhollow Rd Ste 120
Melville, NY 11747-4901

Mailing address

PO Box 464
Huntington Station, NY 11746-0374

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130719000184 NY Practitioner - Family Practice 2264673128 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Digestive Disease Care, PCGroup PAC ID 7113093071, 41 clinicians

Practice addresses (Care Compare)

11014 Jamaica Ave
Richmond Hill, NY 11418-2320
Phone (516) 750-8000

137 Willis Ave
Mineola, NY 11501-2677
Phone (516) 750-8000

380 S Broadway
Hicksville, NY 11801-5033
Phone (516) 750-8000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011915NYMDMental Health Counselor
267336NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, P.C CurrentSince Nov 1, 2015 Accepting new patients
CHS Physician Partners, P.C Family Medicine CurrentSince Nov 1, 2015 Accepting new patients
Sun River Health Inc Current Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
Digestive Disease Care, PC CurrentSince Oct 25, 2022 Accepting new patients
Sun River Health Inc. CurrentSince Apr 1, 2013 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

126 E Main St
Ste 1
East Islip, NY 11730
Phone (631) 277-8367

380 S Broadway
Hicksville, NY 11801
Phone (516) 437-9000

150 Broadhollow Rd
Ste 120
Melville, NY 11747
Phone (631) 450-1400

137 Willis Ave
Ste 110
Mineola, NY 11501
Phone (516) 741-8822

70 N Country Rd
Ste 101
Prt Jefferson, NY 11777
Phone (631) 473-0037

11014 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 335-4747

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

213 Montauk Hwy
West Sayville, NY 11796
Phone (516) 705-3224

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 6

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": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1093957342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 464",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117460374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BROADHOLLOW RD STE 120",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474901",
            "telephone_number": "631-450-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "THOMAS",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-01",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "011915",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "267336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

Verify at the official NPI Registry.