NPIMap

Individual provider Active NPI

Rocco Jason Costabile, MD

  • Family Medicine Physician
  • Devon, PA
National Provider Identifier
1962653998
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD436369 Issued in PA
Practice address
139 Berkley Rd
Devon, PA 19333-1595
Phone
(610) 687-0715
Fax
(484) 580-8561
NPI assigned
Oct 8, 2008
Last updated
Mar 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD436369 PA Primary

Addresses

Primary practice location

139 Berkley Rd
Devon, PA 19333-1595

Mailing address

8019 Frankford Ave
Philadelphia, PA 19136-2786
Phone (215) 332-1300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20090727000138 PA Practitioner - Family PracticePractitioner - Other (Physician) 0042363921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Devon Family Practice LLPGroup PAC ID 8224218078, 8 clinicians

Practice addresses (Care Compare)

139 Berkley Rd
Devon, PA 19333-1544
Phone (610) 687-0715

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Devon Family Practice LLP Family Medicine CurrentSince Feb 1, 2022 Accepting new patients

Locations

139 Berkley Rd
Devon, PA 19333
Phone (610) 687-0715

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EFDDBA

Organizations & group practices 1

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 9

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": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1962653998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8019 FRANKFORD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191362786",
            "telephone_number": "215-332-1300",
            "fax_number": "215-332-5219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 BERKLEY RD",
            "city": "DEVON",
            "state": "PA",
            "postal_code": "193331595",
            "telephone_number": "610-687-0715",
            "fax_number": "484-580-8561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTABILE",
        "first_name": "ROCCO",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-08",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD436369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Devon, PA

Sources for this page

Verify at the official NPI Registry.