CONNOR COSTALES – Sports Physical Therapist, NPI 1053172072

CONNOR COSTALES is a healthcare provider. based in Concord, Massachusetts. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. The NPI Number for CONNOR COSTALES is 1053172072

Main info

Male
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
CONNOR COSTALES
NPI
1053172072
Phone
Not provided
Address
107 COLLEGE RD
Enumeration Date
17 January 2024
Last Update Date
17 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6176236300
Graduation Year
2023 (3 years ago)
PAC ID
6507203171
Group Practice PAC ID
9032163985
Professional Enrollment ID
I20240319003119
Address ID
MA021442950SO259XXSTXX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:2State licenses:0Digital endpointsOther names

2,873 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MA

Provider Addresses for CONNOR COSTALES

  • 107 COLLEGE RD

    CONCORD, MA 017421526

    Phone:

    Type: Mailing

  • 50 BEHARRELL ST STE D

    CONCORD, MA 017421750

    Phone: (617) 932-1027

    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: 2024-03-19

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
I20240319003119IPhysical Therapist In Private PracticeMATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 01742)

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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: 9032163985View full group profile
NameSpecialtyState
-MA
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeNJ
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeNJ
-MA
-MA
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeMA

Reviews

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Frequently asked questions

Does CONNOR COSTALES have a public NPI I can cite?
Public records show CONNOR COSTALES under NPI 1053172072.
Is CONNOR COSTALES currently accepting referrals based on NPI status?
Registry metadata lists CONNOR COSTALES as active.
What type of care does CONNOR COSTALES provide?
CONNOR COSTALES's profile centers on Sports Physical Therapist. Clinical services aligned with this taxonomy classification.
What city is tied to CONNOR COSTALES?
The directory associates CONNOR COSTALES with Concord, Massachusetts. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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