Joseph T Costello, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1086039 Issued in NE

Practice address

1650 Cochrane Circle
Evans Army Community Hospital
Fort Carson, CO 80906

Phone

(573) 999-5952

NPI assigned

Jan 23, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1508004813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIRCLE",
            "address_2": "EVANS ARMY COMMUNITY HOSPITAL",
            "city": "FT. CARSON",
            "state": "CO",
            "postal_code": "80913",
            "telephone_number": "573-999-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIRCLE",
            "address_2": "EVANS ARMY COMMUNITY HOSPITAL",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "80906",
            "telephone_number": "573-999-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "JOSEPH",
        "middle_name": "T",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-23",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1086039",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth Lewis Cornell, M.D.
• William Correa, LSW
• Patricia Corrente, LPC, CAC III
• Deanna M. Coschignano, PH.D.
• Laron Jannice Cosley, RDH
• Katherine Wiggins Coughlin, CNM
• Matthew Harmer Cowell, CRNA
• Susan Cecilia Cowell, CRNA
• Alicia Cox, DO
• Melanie Jo Craig, RD

• Physician Assistant in Fort Carson, CO
• Providers in Fort Carson, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.