DR. CORINNE DIANNE COSTELLIC (DO) – Surgery Physician, NPI 1194955104
Surgery Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
1,444 GENERAL SURGERY in MI
Provider Addresses for DR. CORINNE DIANNE COSTELLIC (DO)
33155 Annapolis St
Wayne, MI 481842405
Phone: (734) 467-2670
Fax: (734) 467-5544
Type: Location
33101 Annapolis St
Wayne, MI 481842405
Phone: (734) 467-2670
Fax: (734) 467-5544
Type: Location
26901 BEAUMONT BLVD SUITE 3D
SOUTHFIELD, MI 480333849
Phone: (947) 522-1860
Fax: (947) 522-0307
Type: Mailing
44199 DEQUINDRE RD STE 612
TROY, MI 480851128
Phone: (248) 964-5170
Fax: (248) 964-5175
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $244.
Total Amount is formed as General ($244) + Research ($0) + Ownership ($0) = $244.
Last reported payment date: 2023-09-06 • Largest payer in this snapshot: Mentor Worldwide LLC ($244).
Total Amount
$244
General + Research + Ownership
Payments
3
Total payment records
General Amount
$244
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Mentor Worldwide LLC | $244 |
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: 2019-02-15
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190215000629 | I | General Surgery | MI | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| G2212 | Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or | 22 | 22 | $0 |
| 19301 | Partial removal of breast | 22 | 19 | $0 |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 21 | 21 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 16 | 15 | $0 |
| 38900 | Imaging of lymph nodes during surgery | 14 | 14 | $0 |
Insurance plans in this area (ZIP 48184)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Hematology/Oncology, Internal Medicine | MI | |
| P S Y C H I A T R Y | MI | |
| - | MI | |
| Internal Medicine, Cardiovascular Disease (Cardiology) | MI | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology) | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI |
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