Mr Matthew D Costello, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Pickerington, Ohio. He graduated from nursing school in 2021 and has 4 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Genesis Anesthesia Providers, Llc and his current practice location is
612 Jillian Frances Cir, Pickerington, Ohio. You can reach out to his office (for appointments etc.) via phone at
(330) 550-5814.
Mr Matthew D Costello is licensed to practice in Ohio (license number APRN.CRNA.0020479) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1538739693.
Provider's Profile
| Full Name | Mr Matthew D Costello |
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| Gender | Male |
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| Speciality | Certified Registered Nurse Anesthetist (crna) |
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| Experience | 4 Years |
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| Location | 612 Jillian Frances Cir, Pickerington, Ohio |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Matthew D Costello graduated from nursing school in 2021
NPI Data:
- NPI Number: 1538739693
- Provider Enumeration Date: 06/30/2021
- Last Update Date: 09/26/2022
Medicare PECOS Information:
- PECOS PAC ID: 9032503073
- Enrollment ID: I20220308001801
Medical Identifiers
Medical identifiers for Mr Matthew D Costello such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1538739693 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 163W00000X | Registered Nurse | RN.418095 (Ohio) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | APRN.CRNA.0020479 (Ohio) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Genesis Anesthesia Providers, Llc | 0042558066 | 62 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Matthew D Costello allows following entities to bill medicare on his behalf.
| Entity Name | Genesis Anesthesia Providers, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1295205433
PECOS PAC ID: 0042558066
Enrollment ID: O20190215001836 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Matthew D Costello is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Matthew D Costello,
1675 W Western Reserve Rd Unit 9c,
Youngstown, OH 44514-4500
Ph: (330) 550-5814 | Mr Matthew D Costello,
612 Jillian Frances Cir,
Pickerington, OH 43147-1566
Ph: (330) 550-5814 |
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