MISS SHANNON BROOK COSTELLA (MSPT, CERT MDT) – Physical Therapist, NPI 1215987201

MISS SHANNON BROOK COSTELLA (MSPT, CERT MDT) is a healthcare provider. based in Oak brook, Illinois. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials MSPT, CERT MDT. They hold a License No. 05007003A (IN). The NPI Number for MISS SHANNON BROOK COSTELLA (MSPT, CERT MDT) is 1215987201

Main info

Female
26 Years Of Experience
Accepts Medicare Assignment
Name
MISS SHANNON BROOK COSTELLA (MSPT, CERT MDT)
NPI
1215987201
Phone
(630) 575-6200
Address
625 ENTERPRISE DR
Enumeration Date
11 May 2006
Last Update Date
20 April 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2194621020
Graduation Year
2000 (26 years ago)
PAC ID
2668569120
Group Practice PAC ID
4789602681
Professional Enrollment ID
I20071030000591
Address ID
IN463832639VA2904XAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,866 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IN

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Provider Addresses for MISS SHANNON BROOK COSTELLA (MSPT, CERT MDT)

  • 625, Enterprise Drive, Oak Brook, DuPage County, Illinois, 60523, United States

    OAK BROOK, IL 605238813

    Phone: (630) 575-6200

    Fax: (630) 928-5040

    Type: Mailing

  • AT&T, 2307, Laporte Avenue, Valparaiso, Porter County, Indiana, 46383, United States

    SUITE 5

    VALPARAISO, IN 463836996

    Phone: (219) 477-4500

    Fax: (219) 477-4567

    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: 2007-10-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20071030000591IPhysical Therapist In Private PracticeINTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities77582$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes67878$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes53871$0
97140Therapy procedure using manual technique, each 15 minutes25543$0
97162Evaluation for physical therapy, typically 30 minutes3836$0
View full utilization report →

Insurance plans in this area (ZIP 60523)

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Provider's Procedures

MISS SHANNON BROOK COSTELLA (MSPT, CERT MDT) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYIN97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes61058
PHYSICAL THERAPYIN97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes24143

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789602681View full group profile
NameSpecialtyState
-IL
Physical Therapist In Private PracticeIL
-IL
-IL
Physical Therapist In Private PracticeVA
-MI
-IL
Physical Therapist In Private PracticeAZ
Physical Therapist In Private PracticeIL
-MI

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Frequently asked questions

How do I look up MISS SHANNON BROOK COSTELLA (MSPT, CERT MDT) by NPI?
Use NPI 1215987201 when you need to reference MISS SHANNON BROOK COSTELLA (MSPT, CERT MDT) in forms, claims, or directories.
Does this profile mean MISS SHANNON BROOK COSTELLA (MSPT, CERT MDT) is currently active?
Yes — MISS SHANNON BROOK COSTELLA (MSPT, CERT MDT) appears active in the national provider directory.
What field does MISS SHANNON BROOK COSTELLA (MSPT, CERT MDT) work in?
You can think of MISS SHANNON BROOK COSTELLA (MSPT, CERT MDT) as practicing within Physical Therapist. Clinical services aligned with this taxonomy classification.
What location metadata exists for MISS SHANNON BROOK COSTELLA (MSPT, CERT MDT)?
The page summarizes Oak Brook, Illinois for MISS SHANNON BROOK COSTELLA (MSPT, CERT MDT); expand the address list for detail.
Is MISS SHANNON BROOK COSTELLA (MSPT, CERT MDT) a real provider?
This page reflects official NPPES data for NPI 1215987201. Always confirm identity and privileges with the practice and licensing boards.

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