Individual provider Active NPI

Ronald D. Kosanke, PA-C

  • Medical Physician Assistant
  • Ganado, TX
National Provider Identifier
1033301866
Registry record updated Aug 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA00585 Issued in TX
Practice address
204 S. 4TH Street
Ganado, TX 77962-0000
Phone
(361) 771-3311
Fax
(361) 771-3081
NPI assigned
Aug 15, 2007
Last updated
Aug 15, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA00585 TX Primary

Addresses

Primary practice location

204 S. 4TH Street
Ganado, TX 77962-0000

Mailing address

204 S. 4TH Street
Ganado, TX 77962-0000
Phone (361) 771-3311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100720000591 TX Practitioner - Physician Assistant 0547392979 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Creighton University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson County Hospital DistrictGroup PAC ID 2365423795, 20 clinicians
El Campo Memorial HospitalGroup PAC ID 6406021765, 27 clinicians
West Wharton County Hospital DistrictGroup PAC ID 7517952047, shared by 93 NPIs, 17 clinicians

Practice addresses (Care Compare)

1013 S Wells St
Edna, TX 77957-4045
Phone (361) 782-7800

204 S
4TH Mid Coast Well Care Ganado
Ganado, TX 77962-2105
Phone (361) 771-3311

303 Sandy Corner Rd
El Campo, TX 77437-9535
Phone (979) 543-6251

305 Sandy Corner Rd
El Campo, TX 77437-9535
Phone (979) 543-5510

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA00585TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
El Campo Memorial Hospital CurrentSince Aug 1, 2020 Accepting new patients
El Campo Memorial Hospital CurrentSince Aug 1, 2020 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

303 Sandy Corner Rd
El Campo, TX 77437
Phone (979) 543-6251

204 S 4th
Ganado, TX 77962
Phone (361) 771-3311

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187136000000",
    "number": "1033301866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 S. 4TH STREET",
            "city": "GANADO",
            "state": "TX",
            "postal_code": "779620000",
            "telephone_number": "361-771-3311",
            "fax_number": "361-771-3081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 S. 4TH STREET",
            "city": "GANADO",
            "state": "TX",
            "postal_code": "779620000",
            "telephone_number": "361-771-3311",
            "fax_number": "361-771-3081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSANKE",
        "first_name": "RONALD",
        "middle_name": "D.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-15",
        "last_updated": "2007-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA00585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ganado, TX

Sources for this page

Verify at the official NPI Registry.