PAUL STEPHEN COSTANZO PA-C NPI 1104845239

NPI Information

  • NPI: 1104845239
  • Provider Name: PAUL STEPHEN COSTANZO, PA-C
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 404 HAZEN ST
    SUITE L3
    PAW PAW, MI
    ZIP 49079
  • Phone: (269) 657-1595

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NPI Details

Paul Stephen Costanzo, PA-C is a medical physician assistant in Paw Paw, MI with 24 years of experience. Paul Stephen Costanzo, PA-C NPI is 1104845239. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

404 HAZEN ST
SUITE L3
PAW PAW, MI
ZIP 49079-040
Phone: (269) 657-1595
Fax: (269) 657-1534

The NPI 1104845239 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Psychiatric diagnostic evaluation with medical services (HCPCS:90792)

The enumeration date for this NPI number is 7/19/2006 and was last updated on 9/27/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedical5601003700MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P17430001MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN
2H06012057MEDICARE PINMICHIGAN
30H060020OTHERMICHIGANBCBSM

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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