Individual provider Active NPI

William Edward Costanzo, MD

  • Cardiovascular Disease Physician
  • Lawrenceville, NJ
National Provider Identifier
1376531517
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA05562600 Issued in NJ
Practice address
3140 Princeton Pike
2ND Floor
Lawrenceville, NJ 08648-2306
Phone
(609) 895-1919
Fax
(609) 895-1200
NPI assigned
Oct 12, 2005
Last updated
May 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD053712L PA
Cardiovascular Disease Physician 207RC0000X 25MA05562600 NJ Primary

Addresses

Primary practice location

3140 Princeton Pike
2ND Floor
Lawrenceville, NJ 08648-2306

Mailing address

104 Pheasant Run
Suite 128
Newtown, PA 18940-3439
Phone (215) 860-3344

Other identifiers 1

IdentifierTypeStateIssuer
7485409MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address william.costanzo.1@12833.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 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

Enrollment IDStateProvider typePAC IDDetails
I20050922000020 NJ Practitioner - Cardiovascular Disease (Cardiology) 1355373689 Reassigns benefits to 1 organization
I20081013000193 PA Practitioner - Cardiovascular Disease (Cardiology) 1355373689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Albany Medical College of Union University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Health Medical GroupGroup PAC ID 7618264532, 442 clinicians

Practice addresses (Care Compare)

104 Pheasant Run
Suite 128
Newtown, PA 18940-3428
Phone (215) 860-3344

3140 Princeton Pike
FL 2
Lawrenceville, NJ 08648-2330
Phone (609) 895-1919

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05562600NJMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Health Medical Group Cardiovascular Disease CurrentSince Apr 1, 2021 Accepting new patients
Trenton Heart Group Cardiovascular Disease Past Accepting new patients

Locations

3131 Princeton Pike
Bldg 5
Lawrenceville, NJ 08648
Phone (609) 844-9661

3140 Princeton Pike
Fl 2
Lawrenceville, NJ 08648
Phone (609) 895-1919

1 Capital Way
Pennington, NJ 08534
Phone (609) 303-4000

1 Union St
Ste 101
Trenton, NJ 08691
Phone (609) 632-0140

1700 Nottingham Way
Ste 108
Trenton, NJ 08619
Phone (609) 303-4870

750 Brunswick Ave
Trenton, NJ 08638
Phone (609) 394-6000

104 Pheasant Run
Ste 128
Newtown, PA 18940
Phone 21586033441218

1201 Langhorne Newtown Rd
Penndel, PA 19047
Phone (215) 710-2100

1050 Stony Hill Rd
Yardley, PA 19067
Phone (215) 504-1761

407 Floral Vale Blvd
Yardley, PA 19067
Phone (215) 750-7150

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12833/brand/1/csg/1/fhir/r4
  • Direct secure messaging: william.costanzo.1@12833.direct.athenahealth.com

Organizations & group practices 2

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.

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1376531517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 PHEASANT RUN",
            "address_2": "SUITE 128",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189403439",
            "telephone_number": "215-860-3344",
            "fax_number": "215-860-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 PRINCETON PIKE",
            "address_2": "2ND FLOOR",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482306",
            "telephone_number": "609-895-1919",
            "fax_number": "609-895-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTANZO",
        "first_name": "WILLIAM",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD053712L",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA05562600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7485409",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "william.costanzo.1@12833.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3140 Princeton Pike",
            "address_2": "2nd Floor",
            "city": "Lawrenceville",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "086482306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lawrenceville, NJ

Sources for this page

Verify at the official NPI Registry.