Individual provider Active NPI

David R. Kosofsky, D.P.M.

  • Podiatrist
  • Nashua, NH
National Provider Identifier
1053397125
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
166 Issued in NH
Practice address
166 Kinsley St Ste 201
Nashua, NH 03060-3676
Phone
(603) 880-9177
Fax
(603) 880-9672
NPI assigned
Dec 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 166 NH Primary

Addresses

Primary practice location

166 Kinsley St Ste 201
Nashua, NH 03060-3676

Mailing address

166 Kinsley St Ste 201
Nashua, NH 03060-3676
Phone (603) 880-9177

Other identifiers 3

IdentifierTypeStateIssuer
0308265Y0NH02OtherNHANTHEM BLUE CROSS BLUE SHIELD
30364153MedicaidNH
DC3586OtherNHPALMETTO GBA RAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040812001207 NH Practitioner - Podiatry 6305818998 Reassigns benefits to 1 organization
I20230926002195 MA Practitioner - Podiatry 6305818998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1982
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

165 Mill St
Leominster, MA 01453-3289
Phone (978) 878-8100

175 Connors St
Gardner, MA 01440-2637
Phone (978) 410-6100

326 Nichols Rd
Fitchburg, MA 01420-1914
Phone (978) 878-8100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue65
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0166NHMDMarriage & Family Therapist
166NHMDSpeech-Language Pathologist
1647MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Hospital of Nashua NH CurrentSince Aug 1, 2017 Accepting new patients
Community Health Connections, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Community Health Connections, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Community Health Connections, Inc. Current Accepting new patients
St Joseph Hospital of Nashua NH CurrentSince Aug 1, 2017 Accepting new patients
Community Health Connections, Inc. Past Accepting new patients

Locations

326 Nichols Rd
Fitchburg, MA 01420
Phone (978) 343-5270

175 Connors St
Gardner, MA 01440
Phone (978) 410-6100

166 Kinsley St
Ste 201
Nashua, NH 03060
Phone (603) 880-9177

172 Kinsley St
Nashua, NH 03060
Phone (603) 595-3926

Organizations & group practices 6

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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1053397125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 KINSLEY ST STE 201",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030603676",
            "telephone_number": "603-880-9177",
            "fax_number": "603-880-9672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 KINSLEY ST STE 201",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030603676",
            "telephone_number": "603-880-9177",
            "fax_number": "603-880-9672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSOFSKY",
        "first_name": "DAVID",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NH",
            "license": "166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SHIELD",
            "identifier": "0308265Y0NH02",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30364153",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD MEDICARE",
            "identifier": "DC3586",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

Verify at the official NPI Registry.