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DR. JOSEPH PATRICK COSTELLO II MD
NPI 1104657733
Student in an Organized Health Care Education/Training Program in Charlotte, NC

Active since August 14, 2024PECOS Enrolled
1000 BLYTHE BLVD., MEB-SUITE 157 - ATTN: INSTITUTIONAL COORDINATOR, CHARLOTTE, NC 28203(605) 610-7904 Get Directions Write a Review

NPPES record last updated: June 23, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 23, 2025, Jun 13, 2025, Aug 14, 2024 (3 updates tracked since 2024).

About Dr. Joseph Patrick Costello Ii Md NPPES

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

DR. JOSEPH PATRICK COSTELLO II MD (NPI 1104657733) is an individual student in an organized health care education/training program in Charlotte, North Carolina and active in the NPI registry since August 2024. He is enrolled in Medicare PECOS and maintains a secondary practice location in Miami.

NPPES Registry Identity

NPI1104657733
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. JOSEPH PATRICK COSTELLO IICredential: MD
Location Address1000 BLYTHE BLVD., MEB-SUITE 157 - ATTN: INSTITUTIONAL COORDINATORCharlotte, NC 28203
Mailing Address108 W Saint Andrews DrSioux Falls, SD 57108-2956 · (605) 610-7904
Phone(605) 610-7904
Sole ProprietorNo
Enumeration DateAugust 14, 2024
Last NPPES UpdateJune 23, 20253 updates tracked since enumeration
NPPES CertifiedJune 23, 2025
✔ NPI 1104657733 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1000 BLYTHE BLVD., Charlotte, NC 28203
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Secondary Practice Location 1

Location 11600 NW 10th Ave # 1140Miami, FL 33136-1015 · Phone (305) 243-3234

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Joseph Patrick Costello Ii 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.

Other Providers at the Same Location NPPES 6

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

BRIAN ZACHARY HEDGES M.D.
Emergency Medicine
1000 BLYTHE BLVD., CMC/DEPARTMENT OF EMERGENCY MEDICINE
CHARLOTTE, NC 28203
Mecklenburg County (704) 355-3181
MARY CATHERINE CONNELL
Student in an Organized Health Care Education/Training Program
1000 BLYTHE BLVD., 4TH FLOOR, MEB
CHARLOTTE, NC 28203
Mecklenburg County (704) 381-6800
DR. EILEEN BETH HITCHO M.D.
Emergency Medicine
1000 BLYTHE BLVD., MEB 3
CHARLOTTE, NC 28203
Mecklenburg County (704) 355-3658
DR. MARIA FRANCES GLENN M.D.
Emergency Medicine
1000 BLYTHE BLVD., MEB3
CHARLOTTE, NC 28203
Mecklenburg County (704) 355-3658
MELISSA A PRESLEY NP
Nurse Practitioner (Family)
1000 BLYTHE BLVD.
CHARLOTTE, NC 28203
Mecklenburg County (704) 355-0720
CHRISTINE MARGARET DETWILER CRNA
Nurse Anesthetist, Certified Registered
1000 BLYTHE BLVD., CAROLINAS MEDICAL CENTER
CHARLOTTE, NC 28203
Mecklenburg County (704) 355-2000

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 Joseph Costello's NPI number?

The NPI number for Joseph Costello is 1104657733. It was assigned to this individual provider in the NPPES registry on August 14, 2024.

Where is Joseph Costello located?

Joseph Costello practices at 1000 Blythe Blvd. Meb-Suite 157 - Attn: Institutional Coordinator, Charlotte, NC 28203. The listed phone number is (605) 610-7904.

What is Joseph Costello's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Joseph Costello enrolled in Medicare?

Yes. Joseph Costello is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Joseph Costello was last updated on June 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.