Nathan M Kostiv, NNP-BC

Primary specialty

Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X

License

95009504 Issued in CA

Practice address

6501 Coyle Ave
Carmichael, CA 95608-0306

Phone

(916) 537-5135

NPI assigned

Jul 18, 2018

Last updated

Jan 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nkostiv616283@hisp.ehr.sutterhealth.org

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

• Regents of the Univ of Ca

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  • NPI 1013906973

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  NPD
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• Regents of the Univ of Ca

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  • NPI 1568455590

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1023594579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 COYLE AVE",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 COYLE AVE",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080306",
            "telephone_number": "916-537-5135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2315 Stockton Blvd",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172201",
            "country_code": "US",
            "telephone_number": "916-734-2011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSTIV",
        "first_name": "NATHAN",
        "middle_name": "M",
        "credential": "NNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-18",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "CA",
            "license": "95009504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Timothy Koch, D.D.S.
• Peter Kolbeck, M.D.
• Benjamin Kong, DPT
• Danton Kono, M.D.
• Susan Shanahan Kostecki, RN, CNNP
• Herman Kothe IV, LCSW
• Vita Koval
• Victor Kozlow
• Jack C Kraft, M.D.
• Steffanie Kramer

• Critical Care Neonatal Nurse Practitioner in Carmichael, CA
• Providers in Carmichael, CA by specialty
• Critical Care Neonatal Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.