NPIMap

Individual provider Active NPI

Elizabeth M Costley, DO

  • Family Medicine Physician
  • Kingston, NY
National Provider Identifier
1679577647
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
208510-1 Issued in NY
Practice address
360 Washington Ave
Kingston, NY 12401-3702
Phone
(845) 338-7140
Fax
(845) 338-7141
NPI assigned
Jun 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 208510-1 NY Primary

Addresses

Primary practice location

360 Washington Ave
Kingston, NY 12401-3702

Mailing address

360 Washington Ave
Kingston, NY 12401-3702
Phone (845) 338-7140

Other identifiers 7

IdentifierTypeStateIssuer
02099250MedicaidNY
228061OtherWELLCARE
69115OtherGHI HMO
EM032V1510OtherEMPIRE BLUE CROSS
855858OtherNYMVP
10053448OtherNYCDPHP
080167991OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040925000056 NY Practitioner - Family Practice 3678542826 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Associates of the Hudson ValleyGroup PAC ID 2860384674, 24 clinicians

Practice addresses (Care Compare)

360 Washington Ave
Kingston, NY 12401-3702
Phone (845) 338-7140

Hospital & facility affiliations

  • Archcare at Home Home health agency, Valhalla, NY, CCN 337140
  • Americare Certified Special Services, Inc Chha Home health agency, Brooklyn, NY, CCN 337290
  • Willcare Chha (Newburgh) Home health agency, Newburgh, NY, CCN 337408
  • Health Quest Home Care, Inc (Certified) Chha Home health agency, Poughkeepsie, NY, CCN 337230
  • Hudson Valley Hospice Hospice, Poughkeepsie, NY, CCN 331521
  • Healthalliance Hospital Marys Avenue Campus Hospital, Kingston, NY, CCN 330224
  • Vassar Brothers Medical Center Hospital, Poughkeepsie, NY, CCN 330023
  • Northern Dutchess Hospital Hospital, Rhinebeck, NY, CCN 330049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
208510-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eugene P Heslin MD PC Family Medicine CurrentSince Jul 1, 1996 Accepting new patients
Medical Associates of the Hudson Valley CurrentSince Jul 1, 2015 Accepting new patients
North Country Emergency Medical Consultants,PC Past Accepting new patients

Locations

360 Washington Ave
Kingston, NY 12401
Phone (845) 338-7140

16 W Bridge St
#P
Saugerties, NY 12477
Phone (845) 246-3000

16 W Bridge St
Saugerties, NY 12477
Phone (845) 246-3000

Interoperability endpoints

  • Direct secure messaging: ecostley@mahv.medentdirect.com

Organizations & group practices 3

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 9

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": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1679577647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 WASHINGTON AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013702",
            "telephone_number": "845-338-7140",
            "fax_number": "845-338-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 WASHINGTON AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013702",
            "telephone_number": "845-338-7140",
            "fax_number": "845-338-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTLEY",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-08",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "208510-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02099250",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "228061",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI HMO",
            "identifier": "69115",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS",
            "identifier": "EM032V1510",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "855858",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10053448",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080167991",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.