Active NPI
James W. Costello, M.D.
- Anesthesiology Physician
- San Diego, CA
National Provider Identifier
1760498901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- A72673
- Practice address
- 3626 Ruffin Rd
San Diego, CA 92123-1810 - Phone
- (858) 565-9666
- Fax
- (858) 565-9441
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | A72673 | CA | Primary |
Addresses
Primary practice location
3626 Ruffin Rd
San Diego, CA 92123-1810
Mailing address
3626 Ruffin Rd
San Diego, CA 92123-1810
Phone (858) 565-9666
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A726730 | Medicaid | CA | |
| 00A726730 | Other | CA | BLUE SHIELD OF CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A72673 | CA | MD | Anesthesiology Physician |
| 72673 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196812800000",
"number": "1760498901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3626 RUFFIN RD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231810",
"telephone_number": "858-565-9666",
"fax_number": "858-565-9441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3626 RUFFIN RD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231810",
"telephone_number": "858-565-9666",
"fax_number": "858-565-9441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTELLO",
"first_name": "JAMES",
"middle_name": "W.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "A72673",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A726730",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF CA",
"identifier": "00A726730",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.