FREDERICK M COSTELLO (NPI# 1285851337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285851337 |
| Entity Type | Individual |
| Full Name | FREDERICK M COSTELLO |
| Credential | MD |
| Practice Address |
520 S. Eagle Rd Ste 3104 Meridian ID 83642 |
| Mailing Address |
190 E Bannock St Boise ID 83712 |
| Practice Telephone | 2088879828 |
| Mailing Telephone | 2088879828 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2011-04-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 200400112 | NC | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
M10231 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
520 S. EAGLE RD STE 3104 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568540714 | Nathan E Green | Internal Medicine | 3525 E Louise Dr, Ste 400, Meridian, ID 83642-6302 | 2006-11-02 |
| 1518994367 | Marshall F Priest | Internal Medicine | 3525 E Louise Dr, Suite 400, Meridian, ID 83642-6351 | 2006-06-27 |
| 1730166307 | Wesley S Bennett | Internal Medicine | 1102 Constitution Ave, Meridian, MS 39301-4001 | 2005-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942771043 | Physician's Choice Cardiology, Pllc | Internal Medicine | 3302 Valencia, Suite 201, Idaho Falls, ID 83404 | 2018-12-16 |
| 1730688748 | Cardiac Cin of Boise LLC | Internal Medicine | 800 W Main St Ste 1460-10, Boise, ID 83702-5945 | 2018-02-05 |
| 1144544644 | Jeffrey J Heslop | Internal Medicine | 6140 W Curtsian, Ste 200, Boise, ID 83704 | 2010-03-26 |
| 1063674505 | Joseph Aloysius Walsh IIi | Internal Medicine | 6140 W Curtisian Ave Ste 100, Boise, ID 83704 | 2008-06-26 |
| 1093972564 | St Patrick Hosp and Health Sci Ctr | Internal Medicine | 203 S. Daisy St, Salmon, ID 83467-4343 | 2008-05-21 |
| 1932153137 | Charles E Eiriksson Jr. | Internal Medicine | 300 E Jeffreson, Ste 101, Boise, ID 83712 | 2006-05-20 |
| 1346713302 | Radial First Holdings | Internal Medicine | 2001 S Woodruff Ave Ste 12b, Idaho Falls, ID 83404-6372 | 2019-01-02 |
| 1730563909 | Radial First Cardiovascular Associates, LLC | Internal Medicine | 2001 S Woodruff Ave, Suite 3, Idaho Falls, ID 83404-6371 | 2015-07-16 |
| 1952670523 | Teton Cardiology PC | Internal Medicine | 3200 Channing Way, Ste A201, Idaho Falls, ID 83404-7546 | 2011-12-27 |
| 1902197866 | Robert Wynn Tonks | Internal Medicine | 775 Pole Line Rd W Ste 112, Twin Falls, ID 83301-5819 | 2011-04-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.