Individual provider Active NPI

John Milton Costello Jr., MD

  • Cardiovascular Disease Physician
  • Washington, PA
National Provider Identifier
1881658185
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD036851E Issued in PA
Practice address
125 N Franklin Dr
Suite 1
Washington, PA 15301-5892
Phone
(724) 225-6500
Fax
(724) 229-2170
NPI assigned
Apr 13, 2006
Last updated
Jun 8, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD036851E PA Primary

Addresses

Primary practice location

125 N Franklin Dr
Suite 1
Washington, PA 15301-5892

Mailing address

125 N Franklin Dr
Suite 1
Washington, PA 15301-5892
Phone (724) 225-6500

Other identifiers 2

IdentifierTypeStateIssuer
0011237940001MedicaidPA
0162212OtherBS

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
I20040203000600 PA Practitioner - Cardiovascular Disease (Cardiology) 5799678934 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Physician Services Cardiovascular Disease CurrentSince Nov 1, 2010 Accepting new patients
Frazier Hart Inc Cardiovascular Disease Past Accepting new patients
North Hills Passavant Cardiology Associates PC Cardiovascular Disease Past Accepting new patients

Locations

125 N Franklin Dr
Ste 1
Washington, PA 15301
Phone (724) 225-6500

155 Wilson Ave
Washington, PA 15301
Phone (724) 223-3342

190 N Main St
Ste 204
Washington, PA 15301
Phone (724) 223-9335

400 Locust Ave
Washington, PA 15301
Phone (724) 222-2577

Organizations & group practices 3

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1881658185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N FRANKLIN DR",
            "address_2": "SUITE 1",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153015892",
            "telephone_number": "724-225-6500",
            "fax_number": "724-225-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N FRANKLIN DR",
            "address_2": "SUITE 1",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153015892",
            "telephone_number": "724-225-6500",
            "fax_number": "724-229-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "JOHN",
        "middle_name": "MILTON",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD036851E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011237940001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "0162212",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, PA

Sources for this page

Verify at the official NPI Registry.