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Active NPI 1952563876 Individual Practitioner Female Practitioner

Mary Joan Costello , CPNP-PC

Nurse Practitioner - Pediatrics • Terrell, TX

Professional Overview & Biography Verified Profile Summary

Mary Costello, CPNP-PC is a registered healthcare professional specializing in Nurse Practitioner - Pediatrics in Terrell, TX. Practice services are available at 1446 W MOORE AVE STE 206 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1446 W Moore Ave Ste 206

Terrell, TX 751602372

Telephone 9722107350
Associated Practice Facility / Clinic
🏢 Pediatric Depot Pllc Facility NPI 1861043259

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Pediatrics in Terrell, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 8.0 Yrs
Regional Practice Density
6 Specialists

Practicing in Terrell, TX (2253 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-07-15
Nurse Practitioner - Pediatrics Primary Specialty

NUCC Taxonomy Code: 363LP0200X

State License TX AP140636

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1952563876 (MO)
Medicaid State Provider ID
ENROLLED (IL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Megan Huckabay , FNP-BC

Nurse Practitioner - Family

NPI 1053036210

Family Nurse Practitioner (Board Certified)

Irene Rono , CPNP-PC

Nurse Practitioner - Pediatrics

NPI 1346967882

CPNPPC

Amanda Guajardo , NP

Nurse Practitioner - Pediatrics

NPI 1497637276

Nurse Practitioner

Colleen Jaurequi

Nurse Practitioner - Pediatrics

NPI 1598366635
Ana Martinez , APRN

Nurse Practitioner - Pediatrics

NPI 1790411429

Advanced Practice Registered Nurse

Deepa David , NP

Nurse Practitioner - Pediatrics

NPI 1851069603

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

18 Historical Events
👤
Provider Name / Credentials Updated July 15, 2025

Recorded as MARY COSTELLO, CPNP-PC

📍
Updated Practice Location June 10, 2025

Registered at 1446 W MOORE AVE STE 206, TERRELL, TX 751602372 (Tel: 9722107350)

📍
Updated Business Mailing Address June 10, 2025

Registered at 1446 W MOORE AVE STE 206, TERRELL, TX 751602372 (Tel: 9722107350)

👤
Provider Name / Credentials Updated June 10, 2025

Recorded as M COSTELLO, CPNP-PC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 10, 2025

Nurse Practitioner (License #AP140636 in TX)

📍
Updated Practice Location April 24, 2019

Registered at 1011 W GROVE ST, KAUFMAN, TX 75142 (Tel: 9729321319)

📍
Updated Business Mailing Address April 24, 2019

Registered at 1011 W GROVE ST, KAUFMAN, TX 751421882 (Tel: 9729321319)

✅
NPI Profile Active January 24, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location January 24, 2018

Registered at 1 CHILDRENS PL, SAINT LOUIS, MO 631101002 (Tel: 3144546121)

📍
Updated Business Mailing Address January 24, 2018

Registered at 1 CHILDRENS PL, NWT 1230, SAINT LOUIS, MO 631101002 (Tel: 3144546121)

👤
Provider Name / Credentials Updated January 24, 2018

Recorded as JOAN COSTELLO, PNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 24, 2018

Nurse Practitioner (License #070459 in MO)

✅
NPI Profile Active November 14, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location November 14, 2016

Registered at 1 CHILDRENS PL, SAINT LOUIS, MO 631101002 (Tel: 3144546121)

📍
Updated Business Mailing Address November 14, 2016

Registered at 1 CHILDRENS PL, NWT 1230, SAINT LOUIS, MO 631101002 (Tel: 3144546121)

👤
Provider Name / Credentials Updated November 14, 2016

Recorded as JOAN COSTELLO, PNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 14, 2016

Nurse Practitioner (License #070459 in MO)

🟢
Initial NPI Registration & Enumeration July 01, 2008

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1952563876
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 01, 2008
Last Update: July 15, 2025
Sole Proprietor: No
Update or Correct Profile

Mailing Address

1446 W Moore Ave Ste 206

Terrell, TX 751602372

Phone: 9722107350

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.