Malissa Ann Costanzo , OWNER
Physician • Forest Lake, MN
844 8th Ave Se
Forest Lake, MN 55025
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
Practice Location & Contact Primary Location
844 8th Ave Se
Forest Lake, MN 55025
What Public CMS Data Show
Physician: NPPES taxonomy is a reported classification, not proof of board certification.
NPI first issued
2018
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians, CMS release of October 2, 2026; Medicare.gov, “Does your provider accept Medicare as full payment?”
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians, CMS release of October 2, 2026.
Sources: CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo · Report an error.
Specialties & License Numbers Reported to NPPES
NUCC Taxonomy Code: 320900000X
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
NUCC Taxonomy Code: 253J00000X
A Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as "24-hour substitute care for children outside their own homes." Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes.
Career & Practice History
NPI enumerated July 30, 2018.
No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from August 2018 to November 2026.
NPI Administrative Meta
Mailing Address
844 8th Ave Se
Forest Lake, MN 550251642
Phone: 6512725608