Individual provider Active NPI

Sara Costello

  • Speech-Language Pathologist
  • Pacific Grove, CA
National Provider Identifier
1669365300
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
667 Lighthouse Ave Ste 201
Pacific Grove, CA 93950-2666
Phone
(831) 318-0558
Fax
(831) 603-6061
NPI assigned
Jun 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X CA Primary

Addresses

Primary practice location

667 Lighthouse Ave Ste 201
Pacific Grove, CA 93950-2666

Mailing address

187 Palm Ave Apt 41
Marina, CA 93933-2931
Phone (619) 972-1460

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250904000898 CA Practitioner - Qualified Speech Language Pathologist 4880196419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

187 Palm Ave Apt
Suite 41
Marina, CA 93933-2931

667 Lighthouse Ave
Suite 201
Pacific Grove, CA 93950-2687

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Monterey Bay Speech Therapy, Inc. Speech-Language Pathologist CurrentSince Aug 20, 2025 Accepting new patients

Locations

667 Lighthouse Ave
Ste 305
Pacific Grove, CA 93950
Phone (831) 318-0558

667 Lighthouse Ave
Ste 201
Pacific Grove, CA 93950
Phone (831) 204-0019

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1669365300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 PALM AVE APT 41",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "939332931",
            "telephone_number": "619-972-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 LIGHTHOUSE AVE STE 201",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939502666",
            "telephone_number": "831-318-0558",
            "fax_number": "831-603-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "SARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacific Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.