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

Mr. Kenneth Patrick Costello

Individual provider Physical Therapist · NPI 1265586572

Mr. Kenneth Patrick Costello is a Physical Therapist in Private Practice in Brentwood, Missouri. Qualified in 2001, 25 years ago. Practices with Athletico Ltd, a 2,186-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
25
Licensed in
MO
In the registry since
2007
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Practice location Address checks out

2937 S Brentwood Blvd
Brentwood, MO 63144
Phone: (314) 961-3804
Fax: (314) 961-1147
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 10859 West Florissant Avenue, Ferguson, MO 63136 — (314) 521-3000
  • 10859 West Florissant Avenue, Ferguson, MO 63136 — (314) 521-3000

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2002005830 (MO)

Record details

NPI number1265586572
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 23, 2007
Last updated in NPPESJuly 1, 2020
Certification dateJuly 1, 2020
Mailing address600 Oakmont Ln, Ste 600c, Westmont, IL 60559-5548

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Athletico Ltd — 2186 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Brentwood