DR. JOHN STANTON III COSTELLO (MD) – Geriatric Medicine (Internal Medicine) Physician, NPI 1184202806
Geriatric Medicine (Internal Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
12,368 INTERNAL MEDICINE in FL
Provider Addresses for DR. JOHN STANTON III COSTELLO (MD)
8613 Old Kings Rd S Ste 602
Ste 602
JACKSONVILLE, FL 322174863
Phone: (904) 493-3390
Fax: (904) 493-3390
Type: Location
10790 RANCHO BERNARDO RD # 4S-205
SAN DIEGO, CA 921275705
Phone: (858) 554-3200
Type: Mailing
10666 N TORREY PINES RD
LA JOLLA, CA 920371027
Phone: (858) 554-3200
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-11-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240205004409 | I | Internal Medicine | CA | TBD |
| I20251117001780 | I | Internal Medicine | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32217)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | FL | |
| Internal Medicine, Pain Management | FL | |
| H O S P I T A L I S T | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Physician Assistant | NY | |
| H O S P I T A L I S T | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL |
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