Corey Joan Costanzo, DO, MPH, MS
Individual provider Active NPI Family Medicine Physician · Barre, MA
NPI 1780144055 · NPPES record last updated Aug 4, 2022
Key facts
- NPI
- 1780144055
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 291048 (MA)
- Practice address
- 151 Worcester Rd
Barre, MA 01005-9099 - Phone
- (978) 355-6321
- Fax
- (978) 355-6549
- NPI assigned
- Mar 22, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220819002795 | MA | Practitioner - Family Practice | 5193051589 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Umass Memorial Medical Group Inc | Family Medicine | Current |
Accepting new patients |
| Umass Memorial Medical Group, Inc. | Current |
Accepting new patients |
Locations
151 Worcester Rd
Barre, MA 01005
Phone (978) 355-6321
55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862
Interoperability endpoints
- ccostanzo280346@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 291048 | MA | Yes |
Addresses
Primary practice location
151 Worcester Rd
Barre, MA 01005-9099
Mailing address
PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885
Other providers in Barre, MA
- Michael Burdett
- Lindsay Callahan
- Susan Frances Coles
- Joy E Cook
- Macario Cudiamat Corpuz Jr.
- Alysia Craig
- Sean W Craig
- Cailee Allyson Dean
- Jason Denoncourt
- Lynne Susan Deschamps
All providers in Barre, MA · Family Medicine Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.