Individual provider Active NPI

Caitlyn Margaret Costanzo, M.D.

  • Surgery Physician
  • Newark, DE
National Provider Identifier
1790075737
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
C1-0026741 Issued in DE
Practice address
4745 Ogletown Stanton Rd Ste 216
Newark, DE 19713-2074
Phone
(302) 737-5444
Fax
(302) 737-2697
NPI assigned
Apr 11, 2011
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD449971 PA
Surgery Physician 208600000X C1-0026741 DE Primary

Addresses

Primary practice location

4745 Ogletown Stanton Rd Ste 216
Newark, DE 19713-2074

Mailing address

1100 Walnut St FL 5
Philadelphia, PA 19107-4944
Phone (215) 955-8666

Other practice location 1

1300 Wolf St Fl 1
Philadelphia, PA 19148
Phone (215) 551-0360

Other practice location 2

1015 Walnut St Ste 620
Philadelphia, PA 19107-5005
Phone (215) 955-6864

Other practice location 3

1100 Walnut St Fl 5
Philadelphia, PA 19107-4944
Phone (215) 955-6750

Other practice location 4

1015 Walnut St Ste 620
Philadelphia, PA 19107-5005
Phone (215) 955-6864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190819000128 PA Practitioner - General Surgery 9638489982 Reassigns benefits to 1 organization
I20240718004973 DE Practitioner - General Surgery 9638489982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

1401 Foulk Rd
Wilmington, DE 19803-2764

4735 Ogletown Stanton Rd
Newark, DE 19713-2072
Phone (302) 623-0200

4755 Ogletown Stanton Rd
Newark, DE 19718-2200

501 W 14TH St
Wilmington, DE 19801-1013

501 W 14TH St FL
6 CCHS Infectious Disease
Wilmington, DE 19801-1013
Phone (302) 320-1300

501 W 14TH St Wilmington Hospital
Wilmington, DE 19801-1013

621 Middletown Odessa Rd
Middletown, DE 19709-9602
Phone (302) 203-2260

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy31

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians Surgery CurrentSince Sep 1, 2019 Accepting new patients
Christiana Care Health Services, Inc Surgery CurrentSince Jul 9, 2024 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Health Services Inc CurrentSince Jul 9, 2024 Accepting new patients
Christiana Care Health Services, Inc Past Accepting new patients
Christiana Care Health Services, Inc. Past Accepting new patients
Colon and Rectal Surgery Associates of Delaware PastSince Jul 21, 2024 Accepting new patients

Locations

4701 Ogletown Stanton Rd
Ste 1500
Newark, DE 19713
Phone (302) 623-4343

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

1100 Walnut St
Fl 5
Philadelphia, PA 19107
Phone (215) 955-6750

1300 Wolf St
Fl 1
Philadelphia, PA 19148
Phone (215) 551-0360

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 7

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 3

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": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1790075737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WALNUT ST FL 5",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074944",
            "telephone_number": "215-955-8666",
            "fax_number": "215-955-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 OGLETOWN STANTON RD STE 216",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132074",
            "telephone_number": "302-737-5444",
            "fax_number": "302-737-2697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Wolf St Fl 1",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19148",
            "country_code": "US",
            "telephone_number": "215-551-0360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1015 Walnut St Ste 620",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191075005",
            "country_code": "US",
            "telephone_number": "215-955-6864",
            "fax_number": "215-955-2878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Walnut St Fl 5",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074944",
            "country_code": "US",
            "telephone_number": "215-955-6750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1015 Walnut St Ste 620",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191075005",
            "country_code": "US",
            "telephone_number": "215-955-6864",
            "fax_number": "215-955-2878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTANZO",
        "first_name": "CAITLYN",
        "middle_name": "MARGARET",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-11",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD449971",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "DE",
            "license": "C1-0026741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.