Kathleen A Costanzo, DO

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

OS014849 Issued in PA

Practice address

311 W 24TH St Ste 305
Erie, PA 16502-2666

Phone

(814) 454-4484

NPI assigned

Sep 7, 2011

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

Other identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Sports MedicineAlso: Family Practice

Education

Lake Erie College of Osteopathic Medicine, Erie, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent Medical Education and Research Institute IncGroup PAC ID 3870405137, 297 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Visiting Nurse Association of Erie County Home health agency, Erie, PA, CCN 397034
• Saint Vincent Hospital Hospital, Erie, PA, CCN 390009

Merit-based Incentive Payment System (MIPS)

Final score

93.9 of 100Reported as apm

Quality

85.02

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• St Vincent Medical Education and Research Institute Inc

  • Internal Medicine Physician
  • Erie, PA
  • NPI 1902881477

  Sports Medicine

  Medicare reassignment Care Compare group NPD
• Saint Vincent Health Center

  • General Acute Care Hospital
  • Erie, PA
  • NPI 1861435042
  NPD (past)
• Saint Vincent Medical Education and Research Institute Inc

  • Clinical Medical Laboratory
  • Erie, PA
  • NPI 1275771230
  NPD (past)

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

• Saint Vincent Health Center

  • General Acute Care Hospital
  • Erie, PA
  • NPI 1861435042
  Care Compare affiliation
• Visiting Nurse Association of Erie County

  • Home Health Agency
  • Erie, PA
  • NPI 1932196136
  Care Compare affiliation

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1528349396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W 24TH ST STE 305",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022666",
            "telephone_number": "814-454-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W 24TH ST STE 305",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022666",
            "telephone_number": "814-454-4484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5165 Imperial Pkwy",
            "address_purpose": "LOCATION",
            "city": "Girard",
            "state": "PA",
            "postal_code": "164179524",
            "country_code": "US",
            "telephone_number": "814-774-3128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4950 Buffalo Rd",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165102304",
            "country_code": "US",
            "telephone_number": "814-899-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTANZO",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-07",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "OS014849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY - WMG",
            "identifier": "30106933",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "441180300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "417898",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1602874",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102645606",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcostanzo148754@direct.ahn.org",
            "affiliation": "N",
            "address_1": "4950 Buffalo Rd",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165102304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Gary Cortina
• Julia D Coseo, PA-C
• Irma Cosic, PA-C
• Andrea Lynn Costello, DPT
• Craig C Costello, D.C.
• Kortnie Cotter
• Douglas L Cottrell, PT
• Kimberley Ann Coughlin, M.A.

• Sports Medicine (Family Medicine) Physician in Erie, PA
• Providers in Erie, PA by specialty
• Sports Medicine (Family Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.