NPIMap

Individual provider Active NPI

Sean Costello, MD

  • Psychiatry Physician
  • Soldotna, AK
National Provider Identifier
1942882774
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
230513 Issued in AK
Practice address
291 N Fireweed St
Soldotna, AK 99669-7540
Phone
(907) 714-5950
NPI assigned
Apr 21, 2021
Last updated
Jul 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X R78572 AZ
Psychiatry Physician 2084P0800X 230513 AK Primary

Addresses

Primary practice location

291 N Fireweed St
Soldotna, AK 99669-7540

Mailing address

250 Hospital PL
Soldotna, AK 99669-6999
Phone (907) 714-4404

Other practice location 1

2800 E Ajo Way
Tucson, AZ 85713-6204
Phone (520) 874-7520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20250808002580 AK Practitioner - Psychiatry 1254732175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

291 N Fireweed St
Soldotna, AK 99669-7540
Phone (907) 714-5950

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Star Medical Imaging PLLC Current Accepting new patients
Central Peninsula General Hospital, Inc CurrentSince Jul 1, 2025 Accepting new patients
Central Peninsula General Hospital Inc CurrentSince Jul 1, 2025 Accepting new patients
Central Peninsula General Hospital Inc. Current Accepting new patients

Locations

250 Hospital Pl
Soldotna, AK 99669
Phone (907) 714-4404

291 N Fireweed St
Soldotna, AK 99669
Phone (907) 262-6454

Interoperability endpoints

  • Direct secure messaging: scostello678302@ak.providencedirect.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 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1942882774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 HOSPITAL PL",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996696999",
            "telephone_number": "907-714-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 N FIREWEED ST",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697540",
            "telephone_number": "907-714-5950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 E Ajo Way",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857136204",
            "country_code": "US",
            "telephone_number": "520-874-7520",
            "fax_number": "520-874-7539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "SEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-21",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": "R78572",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AK",
            "license": "230513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

Verify at the official NPI Registry.