Edward T Costello, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-251 Issued in AR

Practice address

1002 Schneider Dr
Suite 104
Malvern, AR 72104-4816

Phone

(501) 332-7981

Fax

(501) 337-9964

NPI assigned

Jul 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Covenant Health LLCGroup PAC ID 9133519531, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elite Home Health Home health agency, Hot Springs, AR, CCN 047151
• Center Well Home Health Home health agency, Hot Springs, AR, CCN 047105

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: edward.costello@hfclinic.eclinicaldirectplus.com

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.

• Covenant Health LLC

  • Urgent Care Clinic/Center
  • Rockport, AR
  • NPI 1326710468
  Medicare reassignment Care Compare group

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

• Arkansas Homecare of Hot Springs, LLC

  • Home Health Agency
  • Hot Springs, AR
  • NPI 1790724102
  Care Compare affiliation
• Centerwell Certified Healthcare Corp.

  • Home Health Agency
  • Hot Springs, AR
  • NPI 1235161407
  Care Compare affiliation

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1730104340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 SCHNEIDER DR",
            "address_2": "SUITE 104",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721044816",
            "telephone_number": "501-332-7981",
            "fax_number": "501-337-9964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 SCHNEIDER DR",
            "address_2": "SUITE 104",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721044816",
            "telephone_number": "501-332-7981",
            "fax_number": "501-337-9964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "EDWARD",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edward.costello@hfcclinic.eclinicaldirectplus.com",
            "affiliation": "Y",
            "affiliationName": "Shane Higginbotham MD PA",
            "address_1": "1002 Schneider Dr",
            "address_2": "suite 104",
            "city": "Malvern",
            "state": "AR",
            "country_code": "US",
            "postal_code": "721044816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Doris Gail Conway, LPN
• Paula Conway
• Teresa Cook, PROGRAM TECH./MHPP
• Yvonne S Cook, LCSW
• George C Cora, OD
• Leah Harmon Costello, PA
• Coverespite Home, LLC
• Bethany Cox, APRN
• Jacey Cox
• Kristan Crain

• Physician Assistant in Malvern, AR
• Providers in Malvern, AR by specialty
• Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.