Phillip W Kostroun, REGISTERED DIETITIAN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

5107 Medical Dr
San Antonio, TX 78229

Phone

(210) 614-8612

Fax

(210) 615-5596

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Diabetes and Glandular Disease Clinic PAGroup PAC ID 3375443930, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.08 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Cost

76.45

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• TX HMO D-SNP
• TX HMO

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18380/brand/1/csg/1/fhir/r4

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.

• Diabetes and Glandular Disease Clinic PA

  • Endocrinology, Diabetes & Metabolism Physician
  • San Antonio, TX
  • NPI 1427166305
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003924002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5107 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-614-8612",
            "fax_number": "210-615-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5107 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-614-8612",
            "fax_number": "210-615-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTROUN",
        "first_name": "PHILLIP",
        "middle_name": "W",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Gale Kossaeth, RN
• Edward Robert Kost, M.D.
• Melissa Rae Kostel, OTRL
• Sabreenah Kostiouk, MD
• Katherine Elizabeth Kostroun, MD
• Mai Ka Kostur, FNP-BC
• Kristy Y Kosub, MD
• Krystal Kosub, LMFT
• Ashley Kothmann, DDS
• Eithan Kotkowski, MD, PHD

• Registered Dietitian in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.