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DR. JOHN B COSTELLO M.D. NPI 1417062563


NPI Information

NPI: 1417062563
Provider Name: DR. JOHN B COSTELLO, M.D.
Classification: Internal Medicine - 207R00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2821 N BALLAS RD
SUITE 165
SAINT LOUIS, MO
ZIP 63131
Phone: (314) 995-9988
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DR. John B Costello, M.D. is an internal medicine in Saint Louis, MO with 47 years of experience. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. DR. John B Costello, M.D. NPI is 1417062563. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1977

The provider's business location address is:

2821 N BALLAS RD
SUITE 165
SAINT LOUIS, MO
ZIP 63131-321
Phone: (314) 995-9988
Fax: (866) 847-8598

The NPI 1417062563 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 enumeration date for this NPI number is 8/20/2006 and was last updated on 7/15/2013.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RR0500XInternal MedicineRheumatologyR9162MISSOURINo
2207R00000XInternal MedicineR9162MISSOURIYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
187043OTHERFIRST HEALTH
2A10285MEDICARE UPINMISSOURI
32154714OTHERAETNA SPECIALIST
4112155277OTHERRAILROAD MEDICARE
5130260OTHERGHP
65502OTHERBLUE CROSS BLUE SHIELD MO
7000002229MEDICARE ID-TYPE UNSPECIFIEDMISSOURI
8951692OTHERAETNA

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.