Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kent James Costello, PA

Individual provider Physician Assistant · NPI 1992272033

Kent James Costello, PA is a Physician Assistant in Bradford, Pennsylvania. Qualified in 2020, 6 years ago. Practices with St James Hospital, a 130-clinician group and accepts Medicare assignment. Licensed in New York and Pennsylvania.

Years since qualifying
6
Licensed in
NY, PA
In the registry since
2018
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

195 Pleasant St Unit 5
Bradford, PA 16701-1081
Phone: (814) 362-5701
Fax: (814) 362-5702
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MA061922 (PA)
Physician Assistant Taxonomy 363A00000X · Licence 025316 (NY)

Record details

NPI number1992272033
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedOctober 26, 2018
Last updated in NPPESJune 17, 2025
Certification dateOctober 19, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice St James Hospital — 130 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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