Kenneth Patrick Costello
NPI 1265586572ActiveIndividual· Physical Therapist· Brentwood, MO
Physical Therapist with Athletico Ltd, practicing in Brentwood, Missouri. Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1265586572 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Jan 23, 2007 |
| Last updated in NPPES | Jul 1, 2020 |
| Certified by provider | Jul 1, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 2002005830 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (MO) |
|---|
Education and affiliations
| Graduation year | 2001 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Athletico LtdOttawa, IL · 2,200 clinicians
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