DAVID COSTELLO C.R.N.P.
NPI 1104053420
Nurse Practitioner - Family in Gulfport, MS
About David Costello C.r.n.p. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DAVID COSTELLO C.R.N.P. (NPI 1104053420) is an individual family provider in Gulfport, Mississippi, licensed in Mississippi (904287) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS, is affiliated with Memorial Hospital At Gulfport, and is a graduate of Other (2009).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
David Costello C.r.n.p. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show David Costello reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Gulfport, MS 39507
- Reassigned Medicare billing, Mississippi enrollment
- 25 clinicians in this Medicare group
Birmingham, AL 35233
- Reassigned Medicare billing, Alabama enrollment
- 4,494 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 12
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Memorial Hospital At Gulfport
Acute Care Hospitals · Gulfport, MSPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 39501 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
GULFPORT, MS 39501
GULFPORT, MS 39501
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 David Costello's NPI number?
The NPI number for David Costello is 1104053420. It was assigned to this individual provider in the NPPES registry on June 12, 2009.
Where is David Costello located?
David Costello practices at 4300 15th St, Gulfport, MS 39501. The listed phone number is (228) 864-0828.
What is David Costello's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is David Costello enrolled in Medicare?
Yes. David Costello is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for David Costello's services?
According to the CMS Revalidation Reassignment List (October 2026 release), David Costello reassigns Medicare benefits to 2 organizations: Coastal Ear, Nose And Throat, Head And Neck Surgery Associates, PLLC (Gulfport, MS) and University Of Alabama Health Services Foundation, PC (Birmingham, AL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for David Costello's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does David Costello accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 4 other insurers list David Costello as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is David Costello affiliated with any hospitals?
According to CMS data, David Costello is affiliated with Memorial Hospital At Gulfport.
When was this NPI record last updated?
The NPPES record for David Costello was last updated on August 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# David Costello, C.R.N.P. · NPI 1104053420
Family physician in Gulfport, Mississippi. Individual provider, active in the CMS NPPES registry since June 12, 2009.
## Identity
- **NPI:** 1104053420 (Entity type: Individual)
- **Enumerated:** June 12, 2009
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 904287 (Mississippi)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4300 15TH ST, Gulfport, MS 39501-2524
- **Phone:** (228) 864-0828
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Coastal Ear, Nose And Throat, Head And Neck Surgery Associates, PLLC (NPI 1366560435, Gulfport, MS); University Of Alabama Health Services Foundation, PC (NPI 1164617205, Birmingham, AL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2009
## Record status
- **NPPES last updated:** August 9, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1104053420) · Data from the CMS NPPES public registry.