NPIMap

Individual provider Active NPI

Kyle Costenbader

  • Diagnostic Radiology Physician
  • Houston, TX
National Provider Identifier
1699302661
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD493781 Issued in PA
Practice address
6701 Fannin St Ste 470
Houston, TX 77030-2608
Phone
(631) 219-6531
NPI assigned
Mar 26, 2020
Last updated
Apr 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Radiology Physician 2085P0229X W5302 TX
Diagnostic Radiology Physician 2085R0202X MD493781 PA Primary

Addresses

Primary practice location

6701 Fannin St Ste 470
Houston, TX 77030-2608

Mailing address

6701 Fannin St Ste 470
Houston, TX 77030-2608
Phone (832) 824-7237

Other practice location 1

1201 Letort Springs Way
Carlisle, PA 17015-8011
Phone (717) 674-7600

Other practice location 2

36 Robinhood Dr
Etters, PA 17319-9528
Phone (717) 388-7300

Other practice location 3

14781 Wolfe Rd
New Freedom, PA 17349-9571
Phone (717) 326-1880

Other practice location 4

147 Gettys St
Gettysburg, PA 17325-2534
Phone (717) 337-4207

Other practice location 5

169 Martin Ave
Ephrata, PA 17522-1734
Phone (717) 738-6414

Other practice location 6

252 S 4th St
Lebanon, PA 17042-6111
Phone (717) 270-7732

Other practice location 7

35 Monument Rd Ste 201
York, PA 17403-5074
Phone (717) 812-4083

Other practice location 8

35 Erick Rd
Lancaster, PA 17601-3111
Phone (717) 690-0785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20260414001186 PA Practitioner - Diagnostic Radiology 4284063363 Reassigns benefits to 1 organization
I20260526001695 TX Practitioner - Diagnostic Radiology 4284063363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
George Washington University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

169 Martin Ave
Ephrata, PA 17522-1724
Phone (717) 738-6414

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
W5302TXMDPediatric Radiology Physician
MD493781PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children's Physician Group Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1699302661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 FANNIN ST STE 470",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302608",
            "telephone_number": "832-824-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 FANNIN ST STE 470",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302608",
            "telephone_number": "631-219-6531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 Letort Springs Way",
            "address_purpose": "LOCATION",
            "city": "Carlisle",
            "state": "PA",
            "postal_code": "170158011",
            "country_code": "US",
            "telephone_number": "717-674-7600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36 Robinhood Dr",
            "address_purpose": "LOCATION",
            "city": "Etters",
            "state": "PA",
            "postal_code": "173199528",
            "country_code": "US",
            "telephone_number": "717-388-7300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14781 Wolfe Rd",
            "address_purpose": "LOCATION",
            "city": "New Freedom",
            "state": "PA",
            "postal_code": "173499571",
            "country_code": "US",
            "telephone_number": "717-326-1880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "147 Gettys St",
            "address_purpose": "LOCATION",
            "city": "Gettysburg",
            "state": "PA",
            "postal_code": "173252534",
            "country_code": "US",
            "telephone_number": "717-337-4207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "169 Martin Ave",
            "address_purpose": "LOCATION",
            "city": "Ephrata",
            "state": "PA",
            "postal_code": "175221734",
            "country_code": "US",
            "telephone_number": "717-738-6414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "252 S 4th St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170426111",
            "country_code": "US",
            "telephone_number": "717-270-7732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35 Monument Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174035074",
            "country_code": "US",
            "telephone_number": "717-812-4083",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35 Erick Rd",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176013111",
            "country_code": "US",
            "telephone_number": "717-690-0785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTENBADER",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "TX",
            "license": "W5302",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD493781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.