Theodore Gerard Costich, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

187420 Issued in NY

Practice address

41 Maple Rd
Williamsville, NY 14221-2918

Phone

(716) 631-1045

Fax

(716) 631-1365

NPI assigned

Sep 26, 2006

Last updated

Sep 4, 2009By the provider in NPPES

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

Other identifiers 5

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

Specialty

Obstetrics/Gynecology

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kaleida Health Hospital, Buffalo, NY, CCN 330005
• Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078
• Kenmore Mercy Hospital Hospital, Kenmore, NY, CCN 330102
• Roswell Park Cancer Institute Hospital, Buffalo, NY, CCN 330354

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tcostich@gppc.medentdirect.com

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.

• General Physician, PC

  • General Practice Physician
  • Dunkirk, NY
  • NPI 1093959322
  Medicare reassignment Care Compare group NPD
• Maple Medical Services, P.C.

  • Obstetrics Physician
  • Williamsville, NY
  • NPI 1871589861
  Authorized official Same address or phone
• Kaleida Health

  dba Millard Fillmore Suburban Hospital

  • General Acute Care Hospital
  • Williamsville, NY
  • NPI 1053441907
  NPD (past)

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

• Kaleida Health

  dba Millard Fillmore Suburban Hospital

  • General Acute Care Hospital
  • Williamsville, NY
  • NPI 1053441907
  Care Compare affiliation
• Kaleida Health

  dba Degraff Hospital

  • General Acute Care Hospital
  • North Tonawanda, NY
  • NPI 1104956358
  Care Compare affiliation
• Kaleida Health

  dba Golisano Children's Hospital of Buffalo

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1245365196
  Care Compare affiliation
• Kaleida Health

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1366473183
  Care Compare affiliation
• Kaleida Health

  dba Buffalo General Hospital

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1639209596
  Care Compare affiliation
• Kaleida Health

  dba Millard Fillmore Gates Hospital

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1831229780
  Care Compare affiliation
• Kenmore Mercy Hospital

  • General Acute Care Hospital
  • Kenmore, NY
  • NPI 1770598104
  Care Compare affiliation
• Roswell Park Cancer Institute

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1548315401
  Care Compare affiliation
• Sisters of Charity Hospital of Buffalo New York

  • General Acute Care Hospital
  • Cheektowaga, NY
  • NPI 1043455199
  Care Compare affiliation
• Sisters of Charity Hospital of Buffalo New York

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1790727543
  Care Compare affiliation

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252022400000",
    "number": "1245331818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212918",
            "telephone_number": "716-631-1045",
            "fax_number": "716-631-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212918",
            "telephone_number": "716-631-1045",
            "fax_number": "716-631-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTICH",
        "first_name": "THEODORE",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2009-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "187420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA HEALTHCARE PROVID",
            "identifier": "00020006503",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01406720",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OFWNY PROVIDER #",
            "identifier": "005250881",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH PROVID",
            "identifier": "0709667",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS PROVIDER #",
            "identifier": "10109001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward Joseph Cosgrove, MD
• Anthony J Costanzo, D.D.S
• Martyna Costanzo, DNP, WHNP-BC
• Andrea Michele Costello Schilling, DAOM,LA.C
• Leanne Costello, M.A., CF-SLP
• Robert Matthew Cote, D.C.
• Daniel M Cotter, M.D.
• Jerome William Cottone, PH. D.
• Dillon James Coughlin, PA-C
• Julia Marlene Coughlin, OTR

• Obstetrics & Gynecology Physician in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2009; 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.