Individual provider Active NPI

Maria Christine Costello, PA-C

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1619574209
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
025741 Issued in NY
Practice address
210 Crittenden Blvd
Rochester, NY 14642
Phone
(585) 273-3927
NPI assigned
Oct 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25741 NY
Physician Assistant 363A00000X 025741 NY Primary

Addresses

Primary practice location

210 Crittenden Blvd
Rochester, NY 14642

Mailing address

601 Elmwood Ave
Rochester, NY 14642-0002

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mcostello214401@direct.urmc.rochester.edu Direct
Direct Messaging Address mcostello214401@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20201201002379 NY Practitioner - Physician Assistant 3476964131 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Otolaryngology AssociatesGroup PAC ID 2860395795, 36 clinicians

Practice addresses (Care Compare)

2300 W Jefferson Rd FL 1 - Southeast
Pittsford, NY 14534-1090
Phone (585) 758-5700

2365 S Clinton Ave
Suite 200
Rochester, NY 14618-2663
Phone (585) 758-5700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.51 of 100Reported as group
Quality
85.58
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
025741NYMDPhysician Assistant
25741NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Oct 10, 2020 Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Oct 10, 2020 Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
Victor Dermatology PC PastSince Mar 13, 2022 Accepting new patients

Locations

601 Elmwood Ave
#629
Rochester, NY 14642
Phone (585) 276-5181

2365 S Clinton Ave
Ste 200
Rochester, NY 14618
Phone (585) 275-0142

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Organizations & group practices 9

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 2

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": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1619574209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 CRITTENDEN BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14642",
            "telephone_number": "585-273-3927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "MARIA",
        "middle_name": "CHRISTINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2023-07-03",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "25741",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcostello214401@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcostello214401@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.