| Kristopher Costello, CRNA | |
|
3001 Avenue A, Dodge City, KS 67801-2270 | |
| (620) 225-8400 | |
| Not Available |
| Full Name | Kristopher Costello |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 7 Years |
| Location | 3001 Avenue A, Dodge City, Kansas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629586649 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | TMP-155882 (Kansas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| William Bee Ririe Hospital | Ely, NV | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Carson Tahoe Physician Hospital Organization, Llc | 8628465721 | 31 |
| William Bee Ririe Hospital | 9335051747 | 40 |
| Entity Name | William Bee Ririe Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487648804 PECOS PAC ID: 9335051747 Enrollment ID: O20031104000372 |
| Entity Name | Carson Tahoe Physician Hospital Organization, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063169829 PECOS PAC ID: 8628465721 Enrollment ID: O20220419002777 |
| Mailing Address | Practice Location Address |
|---|---|
| Kristopher Costello, CRNA 904 Ragan Rd, Dodge City, KS 67801-2950 Ph: (928) 660-2202 | Kristopher Costello, CRNA 3001 Avenue A, Dodge City, KS 67801-2270 Ph: (620) 225-8400 |
Dr. Dana Alan Reynolds, EDD, MS, ARNP-CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 2811 Avenue A, Apt. A, Dodge City, KS 67801 Phone: 620-371-6140 | |
Martha Jane Marples, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 100 W Ross Blvd, Dodge City, KS 67801 Phone: 620-225-2847 Fax: 620-225-7046 | |
Jason Witzel, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 107 Corral Way Apt A, Dodge City, KS 67801 Phone: 205-585-1301 | |
Mrs. Jacquelyn Edith Rockman, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 500 Cherry St, Dodge City, KS 67801 Phone: 334-549-2903 | |
Terry A Martin, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 100 W Ross Blvd, Dodge City, KS 67801 Phone: 620-225-2847 Fax: 620-225-7046 |