Mackenzie Costello, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R227450 Issued in MD

Practice address

1630 Main St Ste 101
Chester, MD 21619-2792

Phone

(410) 604-6560

Fax

(410) 643-5789

NPI assigned

May 11, 2017

Last updated

Aug 26, 2020By 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 2

Addresses

Other names 1

• Mackenzie Scofield Former name

Medicare fee-for-service enrollment

Enrolled in MD

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

Georgetown University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Maryland Community Medical Group IncGroup PAC ID 3678472214, 446 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of MD Shore Medical Center at Easton Hospital, Easton, MD, CCN 210037
• University of MD Shore Medical Ctr at Chestertown Hospital, Chestertown, MD, CCN 210030

Merit-based Incentive Payment System (MIPS)

Final score

85.26 of 100Reported as group

Quality

81.56

Promoting interoperability

100

Improvement activities

40

Cost

69.29

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• University of Maryland Community Medical Group, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1477530624
  Medicare reassignment Care Compare group NPD
• Luminis Health Medical Group, LLC

  dba Luminis Health Maternal and Fetal Medicine

  • Maternal & Fetal Medicine Physician
  • Annapolis, MD
  • NPI 1073580205
  Medicare reassignment NPD
• Luminis Health Medical Group, LLC

  dba LH Primary Care North Hanson

  • Internal Medicine Physician
  • Bowie, MD
  • NPI 1720835010
  NPD
• Luminis Health Medical Group, LLC

  dba Centreville Family Medicine

  • Family Medicine Physician
  • Centreville, MD
  • NPI 1952564528
  NPD
• University of Maryland Community Medical Group, Inc.

  • Psychiatry Physician
  • La Plata, MD
  • NPI 1679393854
  NPD

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

• Chester River Hospital Center

  dba University of Maryland Shore Medical Center at Chestertown

  • General Acute Care Hospital
  • Chestertown, MD
  • NPI 1679536809
  Care Compare affiliation
• Shore Health System, Inc

  dba UM Shore Medical Center at Dorchester

  • General Acute Care Hospital
  • Cambridge, MD
  • NPI 1194784751
  Care Compare affiliation
• Shore Health System, Inc

  • Clinical Medical Laboratory
  • Easton, MD
  • NPI 1477513273

  Hospital

  Care Compare affiliation
• Shore Health System, Inc

  dba UM Shore Medical Center at Easton

  • General Acute Care Hospital
  • Easton, MD
  • NPI 1669431219
  Care Compare affiliation

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1548797376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 MAIN ST STE 101",
            "city": "CHESTER",
            "state": "MD",
            "postal_code": "216192792",
            "telephone_number": "410-604-6560",
            "fax_number": "410-643-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 MAIN ST STE 101",
            "city": "CHESTER",
            "state": "MD",
            "postal_code": "216192792",
            "telephone_number": "410-604-6560",
            "fax_number": "410-643-5789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "MACKENZIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R227450",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1033652",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACKENZIE",
            "last_name": "SCOFIELD",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Chester, MD
• Providers in Chester, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.