Individual provider Active NPI

Megan Elise Costello, LICSW, MSW

  • Clinical Social Worker
  • Cambridge, MA
National Provider Identifier
1972171916
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LICSW127899 Issued in MA
Practice address
799 Concord Ave
Cambridge, MA 02138-1048
Phone
(518) 391-9914
NPI assigned
Jun 16, 2021
Last updated
Aug 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LICSW127899 MA Primary

Addresses

Primary practice location

799 Concord Ave
Cambridge, MA 02138-1048

Mailing address

163 Pelham Rd
Salem, NH 03079-2855
Phone (518) 391-9914

Other practice location 1

115 Mill St
Belmont, MA 02478-1064
Phone (518) 391-9914

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://patientgateway.massgeneralbrigham.org/mychart-prd/Authentication/Login?

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20240730004327 MA Practitioner - Psychiatry 6406393107 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
Telehealth
Offers telehealth services
Group practices
The McLean Hospital CorporationGroup PAC ID 9436040961, 186 clinicians

Practice addresses (Care Compare)

115 Mill St
Belmont, MA 02478-1064
Phone (617) 855-3450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICSW127899MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The McLean Hospital Corporation Clinical CurrentSince Jun 23, 2024 Accepting new patients

Locations

115 Mill St
Belmont, MA 02478
Phone (617) 855-2000

115 Mill St
#227
Belmont, MA 02478

Interoperability endpoints

  • Direct secure messaging: costello.megan.mcl@direct.partners.masshiway.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1972171916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 PELHAM RD",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030792855",
            "telephone_number": "518-391-9914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 CONCORD AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381048",
            "telephone_number": "518-391-9914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Mill St",
            "address_purpose": "LOCATION",
            "city": "Belmont",
            "state": "MA",
            "postal_code": "024781064",
            "country_code": "US",
            "telephone_number": "518-391-9914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "MEGAN",
        "middle_name": "ELISE",
        "credential": "LICSW, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW127899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://patientgateway.massgeneralbrigham.org/mychart-prd/Authentication/Login?",
            "affiliation": "N",
            "endpointDescription": "patient gateway",
            "address_1": "115 Mill St",
            "city": "Belmont",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024781064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.