Individual provider Active NPI

Lisa Marie Costello, MD, MPH

  • Internal Medicine Physician
  • Morgantown, WV
National Provider Identifier
1356634927
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25300 Issued in WV
Practice address
1 Stadium Drive
Morgantown, WV 26506
Phone
(304) 598-4000
NPI assigned
May 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25300 WV Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1 Stadium Drive
Morgantown, WV 26506

Mailing address

1 Stadium Drive
Morgantown, WV 26506
Phone (304) 598-4000

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address lcostello12071@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address lcostello12071@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address lcostello12071@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20150518000897 WV Practitioner - Pediatric MedicinePractitioner - Internal MedicinePractitioner - Hospitalist 8921328865 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Reynolds Memorial Hospital Inc Internal Medicine CurrentSince Mar 13, 2019 Accepting new patients
West Virginia University Medical Corporation CurrentSince Apr 1, 2015 Accepting new patients
Wheeling Hospital Inc CurrentSince Apr 1, 2022 Accepting new patients
West Virginia University Medical Corporation Internal Medicine Current Accepting new patients
Wheeling Hospital Inc CurrentSince Apr 1, 2022 Accepting new patients
Health and Education Building-Urgent Care CurrentSince Apr 1, 2015 Accepting new patients
Weirton Medical Center, Inc Past Accepting new patients
West Virginia University Hospitals, Inc Past Accepting new patients

Locations

800 Wheeling Ave
Glen Dale, WV 26038
Phone (304) 221-4520

2500 Hospital Dr
Martinsburg, WV 25401
Phone (304) 233-4134

6040 University Town Centre Dr
Morgantown, WV 26501

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

1160 Van Voorhis Rd
Morgantown, WV 26505
Phone (304) 598-1100

1 Medical Park
Wheeling, WV 26003
Phone (304) 243-3124

Interoperability endpoints

  • Direct secure messaging: lcostello12071@direct.wvuhsdirect.com

Organizations & group practices 9

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": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1356634927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 STADIUM DRIVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26506",
            "telephone_number": "304-598-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 STADIUM DRIVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26506",
            "telephone_number": "304-598-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-16",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "25300",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lcostello12071@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6040 University Town Centre Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265012421",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lcostello12071@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6040 University Town Centre Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265012421",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lcostello12071@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6040 University Town Centre Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265012421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.