Individual provider Active NPI

Sophia Madeline Koos, DDS

  • Dentist
  • Yonkers, NY
National Provider Identifier
1043899768
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
062627 Issued in NY
Practice address
984 N Broadway Ste 408
Yonkers, NY 10701-1308
Phone
(914) 376-1100
NPI assigned
Apr 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 062627 NY Primary

Addresses

Primary practice location

984 N Broadway Ste 408
Yonkers, NY 10701-1308

Mailing address

180 Beverly Rd
Mount Kisco, NY 10549-1804
Phone (914) 290-3982

Other practice location 1

150 55th St
Brooklyn, NY 11220-2508
Phone (718) 630-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
062627NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Victor Katsman DDS PLLC Dentist CurrentSince Sep 11, 2022 Accepting new patients

Locations

984 N Broadway
Ste 408
Yonkers, NY 10701
Phone (914) 376-1100

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.

NPI Registry JSON

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1043899768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 BEVERLY RD",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105491804",
            "telephone_number": "914-290-3982",
            "fax_number": "914-241-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984 N BROADWAY STE 408",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011308",
            "telephone_number": "914-376-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 55th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112202508",
            "country_code": "US",
            "telephone_number": "718-630-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOOS",
        "first_name": "SOPHIA",
        "middle_name": "MADELINE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-08",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "062627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.