Active NPI
Lloyd Costello, M.D.
- Family Medicine Physician
- Highland, CA
National Provider Identifier
1922059831
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(6) exclusion effective Jan 19, 2024.
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G53195
- Practice address
- 7000 Boulder Ave
Highland, CA 92346-3348 - Phone
- (909) 862-1191
- NPI assigned
- May 15, 2006
- Last updated
- Oct 27, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G53195 | CA | Primary |
Addresses
Primary practice location
7000 Boulder Ave
Highland, CA 92346-3348
Mailing address
PO Box 10069
San Bernardino, CA 92423-0069
Phone (909) 335-4188
Other practice location 1
1902 Royalty Dr
Suite 130
Pomona, CA 91767-3030
Phone (909) 865-5777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G53195 | CA | MD | Family Medicine Physician |
Interoperability endpoints
- lcostello18934@epiclp.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635292800000",
"number": "1922059831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10069",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924230069",
"telephone_number": "909-335-4188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7000 BOULDER AVE",
"city": "HIGHLAND",
"state": "CA",
"postal_code": "923463348",
"telephone_number": "909-862-1191"
}
],
"practiceLocations": [
{
"address_1": "1902 Royalty Dr",
"address_2": "Suite 130",
"address_purpose": "LOCATION",
"city": "Pomona",
"state": "CA",
"postal_code": "917673030",
"country_code": "US",
"telephone_number": "909-865-5777",
"fax_number": "909-865-5781",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COSTELLO",
"first_name": "LLOYD",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-15",
"last_updated": "2021-10-27",
"certification_date": "2021-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G53195",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Highland, CA
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- Randall E Coriell, M.D.
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- Costco Wholesale Corporation (Costco Hearing Aid #1715)
- Melissa Ann Cox, FNP-C, ENP-C
- Destiny Monique Crew
- Kacee G Cross, LVN
- Crystals Dialysis LLC (Highland Ranch Dialysis Center)
- Cecilie D'Anna, ACSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.