Individual provider Active NPI

Lina Costanzo, DO

  • Internal Medicine Physician
  • Willoughby Hills, OH
National Provider Identifier
1366070088
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34.017418 Issued in OH
Practice address
2570 Som Center Rd
Willoughby Hills, OH 44094-9607
Phone
(440) 943-2500
Fax
(440) 516-8365
NPI assigned
Mar 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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 20A19581 CA
Internal Medicine Physician 207R00000X 34.017418 OH Primary

Addresses

Primary practice location

2570 Som Center Rd
Willoughby Hills, OH 44094-9607

Mailing address

2570 Som Center Rd
Willoughby Hills, OH 44094-9607
Phone (440) 943-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20241127000794 OH Practitioner - Internal MedicinePractitioner - Pediatric Medicine 9931634961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-5433

Hospital & facility affiliations

  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
  • Hillcrest Hospital Hospital, Mayfield Heights, OH, CCN 360230
  • Euclid Hospital Hospital, Euclid, OH, CCN 360082

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A19581CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Oct 3, 2024 Accepting new patients

Locations

11234 Anderson St
Ste C
Loma Linda, CA 92350
Phone (909) 558-4074

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

16215 Madison Ave
Lakewood, OH 44107
Phone (216) 237-5888

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

2570 Som Center Rd
Willoughby Hills, OH 44094
Phone (440) 943-2500

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1585440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1366070088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 SOM CENTER RD",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440949607",
            "telephone_number": "440-943-2500",
            "fax_number": "440-516-8365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 SOM CENTER RD",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440949607",
            "telephone_number": "440-943-2500",
            "fax_number": "440-516-8365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTANZO",
        "first_name": "LINA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-29",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A19581",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34.017418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby Hills, OH

Sources for this page

Verify at the official NPI Registry.