NPIMap

Individual provider Active NPI

Michael W Costello, MD

  • Family Medicine Physician
  • Smithsburg, MD
National Provider Identifier
1740250125
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0041378 Issued in MD
Practice address
22911 Jefferson Blvd
Smithsburg, MD 21783-1617
Phone
(301) 824-3343
NPI assigned
Jan 26, 2006
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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 D0041378 MD Primary

Addresses

Primary practice location

22911 Jefferson Blvd
Smithsburg, MD 21783-1617

Mailing address

22911 Jefferson Blvd
Smithsburg, MD 21783-1617

Other practice location 1

1564 Opossumtown Pike
Frederick, MD 21702-4359
Phone (301) 663-3137

Other practice location 2

1562 Opossumtown Pike
Frederick, MD 21702-4337
Phone (301) 663-3137

Other practice location 3

194 Thomas Johnson Dr Ste A
Frederick, MD 21702
Phone (240) 215-6370

Other identifiers 4

IdentifierTypeStateIssuer
168371300MedicaidMD
W567-0012OtherCAREFIRST BCBS GHMSI
1621121OtherUNITED
522924-09OtherCAREFIRST BCBS MARYLAND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20100330000608 MD Practitioner - Family Practice 4082740931 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pennsylvania State University College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians
Amber Hill Physical Therapy IncGroup PAC ID 8527963917, 336 clinicians

Practice addresses (Care Compare)

11110 Medical Campus Rd
Hagerstown, MD 21742-6700

187 Thomas Johnson Dr
Suite 6
Frederick, MD 21702-4503

22911 Jefferson Blvd
Smithsburg, MD 21783-1617
Phone (301) 824-3343

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.07 of 100Reported as group
Quality
75.5
Promoting interoperability
100
Improvement activities
40
Cost
68.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0041378MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Medical Group LLC Family Medicine CurrentSince Oct 1, 2013 Accepting new patients
Frederick Health Medical Group LLC CurrentSince Oct 1, 2013 Accepting new patients
Medical Practices of Antietam, LLC Family Medicine CurrentSince Nov 16, 2023 Accepting new patients
Frederick Health Medical Group LLC Family Medicine Current Accepting new patients
Medical Practices of Antietam LLC CurrentSince Nov 16, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Meritus Medical Laboratory LLC Past Accepting new patients
Potomac Physicians PA Family Medicine Past Accepting new patients

Locations

1562 Opossumtown Pike
Frederick, MD 21702
Phone (240) 566-4500

194 Thomas Johnson Dr
Frederick, MD 21702
Phone (240) 215-6370

194 Thomas Johnson Dr
Ste A
Frederick, MD 21702
Phone (240) 215-6370

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600

22911 Jefferson Blvd
Smithsburg, MD 21783
Phone (301) 824-1711

3 Byrkit Dr
Williamsport, MD 21795
Phone (301) 582-1150

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1740250125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22911 JEFFERSON BLVD",
            "city": "SMITHSBURG",
            "state": "MD",
            "postal_code": "217831617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22911 JEFFERSON BLVD",
            "city": "SMITHSBURG",
            "state": "MD",
            "postal_code": "217831617",
            "telephone_number": "301-824-3343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1564 Opossumtown Pike",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024359",
            "country_code": "US",
            "telephone_number": "301-663-3137",
            "fax_number": "301-695-6939",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1562 Opossumtown Pike",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024337",
            "country_code": "US",
            "telephone_number": "301-663-3137",
            "fax_number": "301-695-6939",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "194 Thomas Johnson Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "21702",
            "country_code": "US",
            "telephone_number": "240-215-6370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0041378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168371300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS GHMSI",
            "identifier": "W567-0012",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "1621121",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS MARYLAND",
            "identifier": "522924-09",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithsburg, MD

Sources for this page

Verify at the official NPI Registry.