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PRIMARY CARE INTERNAL MEDICINE OF ITHACA, PLLC
NPI 1043736309
Internal Medicine in Ithaca, NY

Active since August 18, 2017CLIA 33D0721297 · Waiver
217 N AURORA ST, ITHACA, NY 14850(607) 273-2811(607) 273-1170 Get Directions Write a Review

NPPES record last updated: August 18, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Primary Care Internal Medicine Of Ithaca, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIMARY CARE INTERNAL MEDICINE OF ITHACA, PLLC (NPI 1043736309) is a healthcare organization registered as an internal medicine in Ithaca, New York and active in the NPI registry since August 2017. The organization holds a CLIA Waiver certificate valid through March 31, 2028 and lists Ann R Costello, Owner, as its authorized official.

NPPES Registry Identity

NPI1043736309
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NamePRIMARY CARE INTERNAL MEDICINE OF ITHACA, PLLC
Location Address217 N AURORA STIthaca, NY 14850-4345
Mailing Address217 N Aurora StIthaca, NY 14850-4345 · (607) 273-2811 · Fax (607) 273-1170
Phone(607) 273-2811
Fax(607) 273-1170
Organization SubpartNo
Authorized OfficialAnn R CostelloOwner · (607) 273-2811
Enumeration DateAugust 18, 2017
✔ NPI 1043736309 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
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.
217 N AURORA ST, Ithaca, NY 14850
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D0721297

Primary Care Internal Medicine Of Ithaca PLLC · Ithaca, NY
Active · expires Mar 31, 2028
CLIA Number33D0721297
Laboratory TypePhysician Office
Certificate Effective DateApril 1, 2026
Certificate Expiration DateMarch 31, 2028
Laboratory DirectorDr. Ann R. Costello
Laboratory Phone(607) 273-2811
Laboratory LocationPrimary Care Internal Medicine Of Ithaca PLLC217 North Aurora Street, Ithaca, NY 14850
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSA IRENE DAURIA ARNP
Nurse Practitioner (Adult Health)
217 N AURORA ST
ITHACA, NY 14850
Tompkins County (607) 273-2811
BONNIE LEFKOWITZ-WHITE FNP
Nurse Practitioner (Family)
217 N AURORA ST
ITHACA, NY 14850
Tompkins County (607) 273-2811
ANN R COSTELLO
Non-Pharmacy Dispensing Site
217 N AURORA ST, SUITE 2
ITHACA, NY 14850
Tompkins County (607) 273-2811
ANN R COSTELLO MD
Internal Medicine
217 N AURORA ST
ITHACA, NY 14850
Tompkins County (607) 273-2811
JUDITH L GRIFFIN MD
Internal Medicine
217 N AURORA ST, #2
ITHACA, NY 14850
Tompkins County (607) 273-2811
NANCY BANFIELD JOHNSON NP
Nurse Practitioner (Adult Health)
217 N AURORA ST
ITHACA, NY 14850
Tompkins County (607) 273-2811
ANN R. COSTELLO, MD
Internal Medicine
217 N AURORA ST
ITHACA, NY 14850
Tompkins County (607) 273-2811
ELIZABETH HOFFMEIER NP
Nurse Practitioner (Family)
217 N AURORA ST
ITHACA, NY 14850
Tompkins County (607) 273-2811

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Primary Care Internal Medicine Of Ithaca, PLLC's NPI number?

The NPI number for Primary Care Internal Medicine Of Ithaca, PLLC is 1043736309. It was assigned to this organization in the NPPES registry on August 18, 2017.

Where is Primary Care Internal Medicine Of Ithaca, PLLC located?

Primary Care Internal Medicine Of Ithaca, PLLC is located at 217 N Aurora St, Ithaca, NY 14850. The listed phone number is (607) 273-2811.

What is Primary Care Internal Medicine Of Ithaca, PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Primary Care Internal Medicine Of Ithaca, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D0721297) is associated with this NPI, valid through March 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Primary Care Internal Medicine Of Ithaca, PLLC was last updated on August 18, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.