Individual provider Active NPI

Gabrielle Jeanne Costello, M.D.

  • Pediatrics Physician
  • Yardley, PA
National Provider Identifier
1841301611
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD047714L Issued in PA
Practice address
680 Heacock Rd Ste 101
Yardley, PA 19067-6346
Phone
(215) 493-6519
NPI assigned
Aug 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD047714L PA Primary

Addresses

Primary practice location

680 Heacock Rd Ste 101
Yardley, PA 19067-6346

Mailing address

1761 Odessa LN
Yardley, PA 19067-2624
Phone (215) 369-4884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200302001618 PA Practitioner - Pediatric Medicine 5294162368 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
STC Pediatrics LLC Pediatrics Current Accepting new patients
STC Pediatrics LLC Pediatrics CurrentSince Dec 1, 2019 Accepting new patients
STC Pediatrics LLC CurrentSince Dec 1, 2019 Accepting new patients
STC Pediatrics LLC Pediatrics Past Accepting new patients

Locations

153 Brodhead Rd
Bethlehem, PA 18017
Phone (484) 526-3200

300 E Hunting Park Ave
Philadelphia, PA 19124
Phone (215) 427-8363

680 Heacock Rd
Ste 101
Yardley, PA 19067
Phone (215) 493-6519

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841301611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 ODESSA LN",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190672624",
            "telephone_number": "215-369-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 HEACOCK RD STE 101",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190676346",
            "telephone_number": "215-493-6519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "GABRIELLE",
        "middle_name": "JEANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD047714L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yardley, PA

Sources for this page

Verify at the official NPI Registry.