Individual provider Active NPI

Yuliya Koshkina, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Norwalk, CT
National Provider Identifier
1003668294
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
12772 Issued in CT
Practice address
761 Main Ave Ste 201
Norwalk, CT 06851-1080
Phone
(203) 853-5000
Fax
(203) 853-5001
NPI assigned
Apr 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 12772 CT Primary

Addresses

Primary practice location

761 Main Ave Ste 201
Norwalk, CT 06851-1080

Mailing address

761 Main Ave Ste 201
Norwalk, CT 06851-1080
Phone (929) 294-1511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240821001838 CT Practitioner - Nurse Practitioner 0042758070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
New York University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

605 W Ave
Norwalk, CT 06850-4000
Phone (203) 853-5000

Hospital & facility affiliations

  • Norwalk Hospital Hospital, Norwalk, CT, CCN 070034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12772CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice CT, Inc. CurrentSince Aug 26, 2024 Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

761 Main Ave
Ste 201
Norwalk, CT 06851
Phone (203) 838-4000

605 West Ave
Norwalk, CT 06850
Phone (203) 838-8844

761 Main Ave
Norwalk, CT 06851
Phone (203) 845-2160

34 Maple St
Norwalk, CT 06850
Phone (203) 852-2000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1003668294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 MAIN AVE STE 201",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511080",
            "telephone_number": "929-294-1511",
            "fax_number": "203-853-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 MAIN AVE STE 201",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511080",
            "telephone_number": "203-853-5000",
            "fax_number": "203-853-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSHKINA",
        "first_name": "YULIYA",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-02",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "12772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.