MARY CATHLEEN COSTELLO
NPI 1164155123
Nurse Practitioner in Tampa, FL

Q: What is Mary Costello's NPI number?

The NPI number for Mary Costello is 1164155123. It was assigned to this individual provider in the NPPES registry on July 7, 2022.

Q: What is Mary Costello's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Costello was last updated on August 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.

Active since July 07, 2022PECOS EnrolledAccepts Medicare Assignment

3000 MEDICAL PARK DR STE 300, TAMPA, FL 33613(813) 497-9661 Get Directions Write a Review

NPPES record last updated: August 10, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 10, 2025, Oct 30, 2023, Aug 23, 2023 and 1 more (4 updates tracked since 2022).

On this page

About Mary Cathleen Costello NPPES

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

MARY CATHLEEN COSTELLO (NPI 1164155123) is an individual nurse practitioner in Tampa, Florida, licensed in Florida (APRN11020897) and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS, is affiliated with Florida Hospital Carrollwood, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1164155123

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMARY CATHLEEN COSTELLO

Location Address3000 MEDICAL PARK DR STE 300Tampa, FL 33613-4696

Mailing Address3000 Medical Park Dr Ste 300Tampa, FL 33613-4696 · (813) 497-9661

Phone(813) 497-9661

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateJuly 7, 2022

Last NPPES UpdateAugust 10, 20254 updates tracked since enumeration

NPPES CertifiedAugust 10, 2025

✔ NPI 1164155123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in FL · APRN11020897

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License APRN11020897 (FL)

3000 MEDICAL PARK DR STE 300, Tampa, FL 33613

Open in Google Maps ↗

Secondary Practice Locations 2

Location 1602 S Audubon Ave Ste BTampa, FL 33609-4217 · Phone (813) 540-4322

Location 22 Tampa General CirTampa, FL 33606-3571 · Phone (813) 821-8038

Other Identifiers 2

Medicaid119949500FL

OtherTB6FPFL · Bcbs

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, AvMed and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mary Cathleen Costello 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.

PECOS PAC ID8820451388

PECOS Enrollment IDI20230830003688

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.

Areas of Expertise CMS Part B claims 2

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

96 services67 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

83 services83 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Florida Hospital Carrollwood

Acute Care Hospitals · Tampa, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number100069

Location7171 N Dale Mabry HwyTampa, FL 33614 · Hillsborough County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33613 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. AUGUSTINE ENYINNA AGOCHA M.D.

Internal Medicine (Cardiovascular Disease)