Individual provider Active NPI

Rosalia Costello

  • Clinical Neuropsychologist
  • Austin, TX
National Provider Identifier
1760740294
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
39319 Issued in TX
Practice address
4910 Mueller Blvd Ste 300
Austin, TX 78723-3079
Phone
(312) 860-2140
NPI assigned
May 3, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X C23472088864 IL
Clinical Neuropsychologist 103G00000X 39319 TX Primary

Addresses

Primary practice location

4910 Mueller Blvd Ste 300
Austin, TX 78723-3079

Mailing address

4910 Mueller Blvd Ste 300
Austin, TX 78723-3079
Phone (312) 860-2140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221026002526 TX Practitioner - Clinical Psychologist 7416323878 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C23472088864ILMDSpecialist
39319TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children'S Medical Group CurrentSince Oct 1, 2022 Accepting new patients
Dell Children'S Medical Group CurrentSince Oct 1, 2022 Accepting new patients
Dell Children'S Medical Group Current Accepting new patients
Seton Family of Doctors Past Accepting new patients

Locations

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

4910 Mueller Blvd
Ste 300
Austin, TX 78723
Phone (512) 324-0907

1000 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 628-1800

Interoperability endpoints

  • Direct secure messaging: rosalia.costello.1@8363.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1760740294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 MUELLER BLVD STE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233079",
            "telephone_number": "312-860-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 MUELLER BLVD STE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233079",
            "telephone_number": "312-860-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "ROSALIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "C23472088864",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "39319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.