Joseph Patrick Costello II, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1000 Blythe Blvd.
Meb-Suite 157 - Attn: Institutional Coordinator
Charlotte, NC 28203

Phone

(605) 610-7904

NPI assigned

Aug 14, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1104657733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W SAINT ANDREWS DR",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082956",
            "telephone_number": "605-610-7904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD.",
            "address_2": "MEB-SUITE 157 - ATTN: INSTITUTIONAL COORDINATOR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28203",
            "telephone_number": "605-610-7904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 NW 10th Ave # 1140",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361015",
            "country_code": "US",
            "telephone_number": "305-243-3234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "JOSEPH",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-14",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Costco Wholesale Corporation
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• Jose Perez Coste, MD
• Corinna M Costello, PHD, LPC, ATR-BC
• Cotswold Chiropractic Center PLLC
• Cotswold Clinician Support Services
• Cotswold Family Dentistry
• Cotswold Family Medicine
• Cottage Home Care NC LLC

• Student in an Organized Health Care Education/Training Program in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Student in an Organized Health Care Education/Training Program in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.