JOHN COSTELLO MD
NPI 1053302992
Pediatrics - Pediatric Critical Care Medicine in Charleston, SC

Q: What is John Costello's NPI number?

The NPI number for John Costello is 1053302992. It was assigned to this individual provider in the NPPES registry on October 31, 2005.

Q: What is John Costello's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Q: When was this NPI record last updated?

The NPPES record for John Costello was last updated on February 18, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 31, 2005PECOS Enrolled

171 ASHLEY AVE, CHARLESTON, SC 29425(843) 792-1414 Get Directions Write a Review

NPPES record last updated: February 18, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 18, 2022, Jul 9, 2018 (2 updates tracked since 2018).

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About John Costello Md NPPES

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

JOHN COSTELLO MD (NPI 1053302992) is an individual pediatric critical care medicine provider in Charleston, South Carolina, licensed in South Carolina (52686) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053302992

Entity TypeIndividualMale

Primary Taxonomy2080P0203X

Provider Legal NameJOHN COSTELLOCredential: MD

Location Address171 ASHLEY AVECharleston, SC 29425

Mailing AddressPo Box 751461Charlotte, NC 28275-1461 · (843) 792-6200 · Fax (603) 893-8886

Phone(843) 792-1414

Sole ProprietorNo

Enumeration DateOctober 31, 2005

Last NPPES UpdateFebruary 18, 20222 updates tracked since enumeration

NPPES CertifiedFebruary 18, 2022

✔ NPI 1053302992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0203X

License✔ Licensed in SC · 52686

Definition

A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.

Also ListedPediatricsTaxonomy 208000000X · License 217260 (MA)

Also ListedPediatrics · Pediatric CardiologyTaxonomy 2080P0202X · License 52686 (SC)

171 ASHLEY AVE, Charleston, SC 29425

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Other Identifiers 12

OtherTUFTS HEALTH PLANMA · 217260

Other26528MA · Bmc Healthnet

Other3253447MA · Aetna Ma

OtherJ26530MA · Hmo Blue

Medicaid2014416MA

Other32292MA · Neighborhood Health Plan

OtherAA9211MA · Harvard Pilgrim

MedicaidJC51504RI

Other97288001MA · Network Health

Other25-01706MA · United Healthcare Ma

OtherJ26530MA · Bcbs Ma

OtherJ26530MA · Blue Care Elect

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina, First Choice Next.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

John Costello Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

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

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