Mary Colleen Costello, MD

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

DR.0070286 Issued in CO

Practice address

13123 E 16TH Ave
Aurora, CO 80045-7106

Phone

(720) 777-1234

NPI assigned

May 5, 2011

Last updated

Apr 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, CO2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mcostello261963@direct.childrenscolorado.org

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.

• University Physicians Incorporated

  dba CU Medicine

  • Internal Medicine Physician
  • Aurora, CO
  • NPI 1962461889

  Emergency Medicine

  Medicare reassignment NPD
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  TN

  Medicare reassignment NPD
• Children's Hospital Colorado

  • Clinical Social Worker
  • Aurora, CO
  • NPI 1174282776
  NPD
• University Physicians Incorporated

  dba Children's Hospital Colorado - Colorado Springs

  • Pediatrics Physician
  • Colorado Springs, CO
  • NPI 1346744083
  NPD
• University Physicians, Incorporated

  dba CU Sports Medicine Colorado Center

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Denver, CO
  • NPI 1275045049
  NPD

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

{
    "created_epoch": "1304553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1306138672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "720-777-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2018 W Clinch Ave",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379162301",
            "country_code": "US",
            "telephone_number": "865-541-8000",
            "fax_number": "865-985-7077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "MARY",
        "middle_name": "COLLEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-05",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "MD47246",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD47246",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "TN",
            "license": "MD47246",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "CO",
            "license": "DR.0070286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Costco Wholesale Corporation (Costco Optical #439)
• Costco Wholesale Corporation
• Costco Wholesale Corporation (Costco Hearing Aid #439)
• Katherine Costello, APN
• Lisa Humphrey Costello, PH.D., NCSP
• Suzanne Cota, RN, MSN, CRNP
• Jillian Mayer Cotter, M.D.
• Alyssa Cottle
• Yahdi D Cotto-Jorge, D.C.
• Jake Logan Cotton, MD

• Pediatric Emergency Medicine (Pediatrics) Physician in Aurora, CO
• Providers in Aurora, CO by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.