Active NPI
David Costello, PT
- Physical Therapist
- Ypsilanti, MI
National Provider Identifier
1609377480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501010673
- Practice address
- 5333 McAuley Dr
Ypsilanti, MI 48197-1014 - Phone
- (734) 712-2754
- Fax
- (734) 712-8678
- NPI assigned
- Feb 27, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501010673 | MI | Primary |
Addresses
Primary practice location
5333 McAuley Dr
Ypsilanti, MI 48197-1014
Mailing address
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 655-3109
Other practice location 1
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-0190
Other practice location 2
1 Ford Pl
Detroit, MI 48202-3450
Phone (248) 386-5336
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dcostello691591@direct.hfhs.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501010673 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618272000000",
"number": "1609377480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3601 W 13 MILE RD",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480736712",
"telephone_number": "248-655-3109",
"fax_number": "248-898-0451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5333 MCAULEY DR",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481971014",
"telephone_number": "734-712-2754",
"fax_number": "734-712-8678"
}
],
"practiceLocations": [
{
"address_1": "3601 W 13 Mile Rd",
"address_purpose": "LOCATION",
"city": "Royal Oak",
"state": "MI",
"postal_code": "480736712",
"country_code": "US",
"telephone_number": "248-898-0190",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Ford Pl",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482023450",
"country_code": "US",
"telephone_number": "248-386-5336",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COSTELLO",
"first_name": "DAVID",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-27",
"last_updated": "2021-04-13",
"certification_date": "2021-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501010673",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dcostello691591@direct.hfhs.org",
"affiliation": "N",
"address_1": "2799 W Grand Blvd",
"city": "Detroit",
"state": "MI",
"country_code": "US",
"postal_code": "482022608",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.