Christine Marie Costanzo, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

36169-020 Issued in WI

Practice address

408 S Baldwin St
Madison, WI 53703-4805

Phone

(608) 257-1724

Fax

(608) 257-2371

NPI assigned

Dec 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Psychiatry

Education

Ohio State University College of Medicine, 1993

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Christine Costanzo M.D. LLC

  • Psychiatry Physician
  • Madison, WI
  • NPI 1487950812
  NPD (past) Authorized official
• L & D Enterprises, Inc.

  dba Prairie Counseling Services

  • Professional Counselor
  • Sun Prairie, WI
  • NPI 1225005887
  NPD (past)
• Michael D Plooster MD SC

  • Orthopaedic Surgery Physician
  • Baraboo, WI
  • NPI 1447232624
  NPD (past)
• Pathway to Wellness Community Clinic SC

  • Clinical Social Worker
  • Prairie Du Sac, WI
  • NPI 1528413739
  NPD (past)
• The Redi Clinic of Wauwatosa, SC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wauwatosa, WI
  • NPI 1043228505
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1144398546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 S BALDWIN ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53703",
            "telephone_number": "608-257-1724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 S BALDWIN ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537034805",
            "telephone_number": "608-257-1724",
            "fax_number": "608-257-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTANZO",
        "first_name": "CHRISTINE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "36169-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32125800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela G Cortes, MS, LPC-IT
• Kathleen Cortez, APN-CRNA
• Patrick Cory, PHARM.D.
• Julia Cosgrove
• Pippa Froukte Cosper, MD
• Erin Costanzo, PHD
• Costco Wholesale Corporation (Costco Pharmacy #1710)
• Cecilia Elizabeth Costello, RPH
• Eric James Cotter, MD
• Lisa Marie Cotter, MD

• Psychiatry Physician in Madison, WI
• Providers in Madison, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.