Mary Keely Costello Bennett, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

0024170989 Issued in VA

Practice address

1250 E Marshall St
Emergency Medicine
Richmond, VA 23298-5051

Phone

(804) 828-5650

Fax

(804) 828-4686

NPI assigned

Jul 10, 2013

Last updated

Feb 7, 2019By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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 1

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical College of Virginia Hospitals Hospital, Richmond, VA, CCN 490032

Merit-based Incentive Payment System (MIPS)

Final score

83.95 of 100Reported as group

Quality

69.91

Promoting interoperability

99

Improvement activities

40

Cost

77.42

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• MCV Associated Physicians

  dba MCV Physicians

  • Anesthesiology Physician
  • Richmond, VA
  • NPI 1710959457
  Medicare reassignment Care Compare group NPD

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

• Virginia Commonwealth University Health System Authority

  dba Medical College of Virginia Hospitals

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1013091727
  Care Compare affiliation
• Virginia Commonwealth University Health System Authority

  dba VCU Medical Center

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1437175734
  Care Compare affiliation

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1417398124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91734",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232911734",
            "telephone_number": "804-358-6100",
            "fax_number": "804-342-7619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E MARSHALL ST",
            "address_2": "EMERGENCY MEDICINE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985051",
            "telephone_number": "804-828-5650",
            "fax_number": "804-828-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "MARY",
        "middle_name": "KEELY COSTELLO",
        "name_prefix": "Mrs.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-10",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024170989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel Alan Bennett, M.D.
• Jonathan David Bennett, M.D.
• Lillie Robinson Bennett, MD
• Lisa Bennett, MD
• Marvin Stephone Bennett
• Richard Leroy Bennett Jr., MD
• Ines Benothmane, DPT
• Halimah Bakir Benson, LPN
• Kristen Frances Benson
• Larry L Benson, MD

• Acute Care Nurse Practitioner in Richmond, VA
• Providers in Richmond, VA by specialty
• Acute Care Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.