NPIMap

Individual provider Active NPI

David M Costello, P.A. - C

  • Physician Assistant
  • Winter Park, FL
National Provider Identifier
1972588408
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2227 Issued in FL
Practice address
1285 Orange Ave
Winter Park, FL 32789-4984
Phone
(407) 599-3710
Fax
(407) 643-2807
NPI assigned
Dec 7, 2005
Last updated
Nov 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2227 FL Primary

Addresses

Primary practice location

1285 Orange Ave
Winter Park, FL 32789-4984

Mailing address

1285 Orange Ave
Winter Park, FL 32789-4984
Phone (407) 599-3710

Other identifiers 1

IdentifierTypeStateIssuer
290340700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070615000044 FL Practitioner - Physician Assistant 0042319030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wake Forest University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians

Practice addresses (Care Compare)

1111 W Fairbanks Ave
Winter Park, FL 32789-4777

1200 Lexington Green LN
Sanford, FL 32771-1013

1285 Orange Ave
Winter Park, FL 32789-4984
Phone (407) 647-2287

32 W Gore St
Orlando, FL 32806-1134

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince May 30, 2020 Accepting new patients
Orlando Health Medical Group Inc CurrentSince May 30, 2020 Accepting new patients
West Orange Orthopaedics & Sports Medicine PA Past Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1285 Orange Ave
Winter Park, FL 32789
Phone (407) 647-2287

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: costello@jortho1643.srs-direct.com
  • Direct secure messaging: dcostello102533@orlandohealth.medalliesdirect.net

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 3

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1972588408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 ORANGE AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894984",
            "telephone_number": "407-599-3710",
            "fax_number": "407-643-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 ORANGE AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894984",
            "telephone_number": "407-599-3710",
            "fax_number": "407-643-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "P.A. - C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA2227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290340700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.