NPIMap

Individual provider Active NPI

Cory Nathan Costello, M.D.

  • Family Medicine Physician
  • Plano, TX
National Provider Identifier
1861560138
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
S3145 Issued in TX
Practice address
4800 Hedgcoxe Rd Ste 200
Plano, TX 75024-2402
Phone
(469) 800-6120
Fax
(469) 800-6129
NPI assigned
Dec 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34362 TN
Family Medicine Physician 207Q00000X S3145 TX Primary

Addresses

Primary practice location

4800 Hedgcoxe Rd Ste 200
Plano, TX 75024-2402

Mailing address

4800 Hedgcoxe Rd Ste 200
Plano, TX 75024-2402
Phone (469) 800-6120

Other practice location 1

550 Pope Ave
Munson Army Health Center, Ms. Cotton, Credentials
Fort Leavenworth, KS 66027-2332
Phone (913) 684-6562

Other identifiers 2

IdentifierTypeStateIssuer
S3145OtherTXTEXAS MEDICAL BOARD
34362OtherTNSTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191230000800 TX Practitioner - Family Practice 0143654160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York Medical College, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

4800 Hedgcoxe Rd
Suite 200
Plano, TX 75024-2402
Phone (972) 860-8750

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34362TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Family Medicine CurrentSince Jan 1, 2023 Accepting new patients
Healthtexas Provider Network CurrentSince Jan 1, 2023 Accepting new patients
Healthtexas Provider Network Family Medicine Current Accepting new patients
Healthtexas Provider Network Family Medicine Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

4800 Hedgcoxe Rd
Ste 200
Plano, TX 75024
Phone (469) 800-6120

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • Direct secure messaging: ccostello568571@direct.sw.org

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.

Hospital & facility affiliations 6

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": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1861560138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 HEDGCOXE RD STE 200",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242402",
            "telephone_number": "469-800-6120",
            "fax_number": "469-800-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 HEDGCOXE RD STE 200",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242402",
            "telephone_number": "469-800-6120",
            "fax_number": "469-800-6129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Pope Ave",
            "address_2": "Munson Army Health Center, Ms. Cotton, Credentials",
            "address_purpose": "LOCATION",
            "city": "Fort Leavenworth",
            "state": "KS",
            "postal_code": "660272332",
            "country_code": "US",
            "telephone_number": "913-684-6562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "CORY",
        "middle_name": "NATHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-02",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "34362",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S3145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "S3145",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "34362",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.