Individual provider Active NPI

Thomas Costello, MD

  • Diagnostic Radiology Physician
  • Las Vegas, NV
National Provider Identifier
1477590560
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
5527 Issued in NV
Practice address
2020 Palomino LN
Suite 100
Las Vegas, NV 89106-4894
Phone
(702) 759-8600
Fax
(702) 384-1815
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 5527 NV Primary

Addresses

Primary practice location

2020 Palomino LN
Suite 100
Las Vegas, NV 89106-4894

Mailing address

2020 Palomino LN
Suite # 100
Las Vegas, NV 89106-4894
Phone (702) 759-8600

Other identifiers 3

IdentifierTypeStateIssuer
200290011MedicaidNV
200470490AMedicaidOK
1477590560MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20110204000239 NV Practitioner - Diagnostic Radiology 1850205345 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Nevada School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shelin Agrawal and Hyer PLLCGroup PAC ID 5890955959, 65 clinicians
Ellis Bandt Birkin Kollins and Wong PLLCGroup PAC ID 4486568946, 68 clinicians

Practice addresses (Care Compare)

Las Vegas, NV 89106
Phone (702) 759-8600

Las Vegas, NV 89117
Phone (702) 759-8600

Hospital & facility affiliations

  • Spring Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290046
  • Summerlin Hospital Medical Center Hospital, Las Vegas, NV, CCN 290041
  • Centennial Hills Hospital Medical Center Hospital, Las Vegas, NV, CCN 290054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5527NVMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group Rhodes P C CurrentSince Aug 13, 2019 Accepting new patients
Shelin Agrawal and Hyer PLLC Diagnostic Radiology CurrentSince Jan 21, 2012 Accepting new patients
Ellis Bandt Birkin Kollins & Wong PLLC Diagnostic Radiology CurrentSince Jan 1, 1983 Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Aug 13, 2019 Accepting new patients

Locations

901 Adams Blvd
Boulder City, NV 89005
Phone (702) 293-4111

3175 Saint Rose Pkwy
Ste 130
Henderson, NV 89052
Phone (702) 932-2740

2811 W Horizon Ridge Pkwy
Henderson, NV 89052

1050 W Galleria Dr
Henderson, NV 89011
Phone (702) 723-4124

7200 Cathedral Rock Dr
Ste 230
Las Vegas, NV 89128
Phone (702) 623-7568

5400 S Rainbow Blvd
Las Vegas, NV 89118
Phone (702) 252-7342

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

657 N Town Center Dr
Las Vegas, NV 89144
Phone (702) 233-7571

6900 N Durango Dr
Las Vegas, NV 89149
Phone (702) 380-1964

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

2020 Palomino Ln
Ste 100
Las Vegas, NV 89106
Phone (702) 759-8779

6675 S Cimarron Rd
Ste 105
Las Vegas, NV 89113

3920 S Eastern Ave
Ste 100
Las Vegas, NV 89119
Phone (702) 759-8779

1397 S Loop Rd
Ste 100
Pahrump, NV 89048

1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500

Interoperability endpoints

  • Direct secure messaging: tcostello11561@direct.umcsn.com

Organizations & group practices 4

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 8

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1477590560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN",
            "address_2": "SUITE # 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600",
            "fax_number": "702-384-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600",
            "fax_number": "702-384-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "5527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200290011",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200470490A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477590560",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.