Individual provider Active NPI

Kamrie Christine Costello, FNP-C

  • Otolaryngology Physician
  • Olean, NY
National Provider Identifier
1407378383
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
SP017667 Issued in PA
Practice address
535 Main St Ste 1
Olean, NY 14760-1593
Phone
(716) 372-0141
NPI assigned
Jul 12, 2017
Last updated
Apr 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP017667 PA
Otolaryngology Physician 207Y00000X SP017667 PA Primary

Addresses

Primary practice location

535 Main St Ste 1
Olean, NY 14760-1593

Mailing address

1001 E 2ND St
Coudersport, PA 16915-8161
Phone (814) 274-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171005001810 PA Practitioner - Nurse Practitioner 8729353412 Reassigns benefits to 3 organizations
I20210113000271 NY Practitioner - Nurse Practitioner 8729353412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charles Cole Memorial HospitalGroup PAC ID 3779487475, 66 clinicians

Practice addresses (Care Compare)

1001 E 2ND St
Coudersport, PA 16915-8161

11 8TH St
Coudersport, PA 16915-1207
Phone (814) 274-1111

15 Meade St
Wellsboro, PA 16901-1813
Phone (814) 274-5243

Hospital & facility affiliations

  • Upmc Cole Hospital, Coudersport, PA, CCN 391313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP017667PAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bradford Family Medicine, Inc. CurrentSince Sep 14, 2017 Accepting new patients
Olean Medical Practice PLLC CurrentSince Jun 1, 2022 Accepting new patients
Charles Cole Memorial Hospital CurrentSince Feb 24, 2025 Accepting new patients
Charles Cole Memorial Hospital CurrentSince Feb 24, 2025 Accepting new patients
General Physician, PC CurrentSince Jun 1, 2022 Accepting new patients

Locations

535 Main St
Olean, NY 14760
Phone (716) 372-0141

535 Main St
Ste 1
Olean, NY 14760
Phone (716) 372-0141

14 N 3rd St
Bradford, PA 16701
Phone (814) 362-6962

1001 E 2nd St
Coudersport, PA 16915
Phone (814) 274-7407

Interoperability endpoints

  • Direct secure messaging: kamrie.c.costello@upmcdirect.com
  • Direct secure messaging: kcostello65684@upmc.direct-ci.com

Organizations & group practices 5

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 2

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": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1407378383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E 2ND ST",
            "city": "COUDERSPORT",
            "state": "PA",
            "postal_code": "169158161",
            "telephone_number": "814-274-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 MAIN ST STE 1",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601593",
            "telephone_number": "716-372-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "KAMRIE",
        "middle_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017667",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "SP017667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olean, NY

Sources for this page

Verify at the official NPI Registry.