Robert Costello MD LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ROBERT COSTELLO MD LLC

Practice address

220 Hamburg Tpke
Suite 8
Wayne, NJ 07470-2110

Phone

(973) 942-5230

Fax

(973) 942-6652

NPI assigned

Sep 23, 2015

Organization subpart

No

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

Authorized official

Name

Robert E Costello Jr., MDNPI 1326454638

Title

Authorized Representative

Phone

(201) 390-8705

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Costello, M.D.

  • Internal Medicine Physician
  • Wayne, NJ
  • NPI 1326454638
  Medicare reassignment NPD Authorized official
• John M Morone, MD

  • Internal Medicine Physician
  • Wayne, NJ
  • NPI 1346312774
  NPD (past)

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1790154540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 HAMBURG TPKE",
            "address_2": "SUITE 8",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702110",
            "telephone_number": "973-942-5230",
            "fax_number": "973-942-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 HAMBURG TPKE",
            "address_2": "SUITE 8",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702110",
            "telephone_number": "973-942-5230",
            "fax_number": "973-942-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT COSTELLO MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "201-390-8705",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ernesto Rivera, LCSW
• Andrea Michelle Rivers, ANP
• Riverview Pharmacy LLC
• Taylor Rizza
• RKG Group of Medical Services Inc
• Theodore Roberto, D.P.M.
• Melissa Roberts
• Wayne David Robertson, LCSW, LCADC
• Robin Kahwaty O D L L C
• Mamilda Robinson, DNP, APN, PMHNP-BC

• Internal Medicine Physician in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.