Individual provider Active NPI

David James Koster, M.D.

  • Hematology & Oncology Physician
  • Fresno, CA
National Provider Identifier
1063406163
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
G64875 Issued in CA
Practice address
7130 N Millbrook Ave
Suite 100
Fresno, CA 93720-3347
Phone
(559) 326-1238
Fax
(559) 326-1230
NPI assigned
Sep 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X G64875 CA Primary

Addresses

Primary practice location

7130 N Millbrook Ave
Suite 100
Fresno, CA 93720-3347

Mailing address

7130 N Millbrook Ave
Suite 100
Fresno, CA 93720-3347
Phone (559) 447-4949

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ75882ZMedicaidCA
PO1345510OtherCARAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dkoster1657926@oc.providencedirect.org

Medicare participation

Medicare enrollment files
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G64875CAMDHematology & Oncology Physician

Interoperability endpoints

  • Direct secure messaging: david.koster@ccare.direct.varian.com
  • Direct secure messaging: dkoster1657926@oc.providencedirect.org
  • Direct secure messaging: dkoster687959@hisp.ehr.sutterhealth.org

NPI Registry JSON

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1063406163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7130 N MILLBROOK AVE",
            "address_2": "SUITE 100",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203347",
            "telephone_number": "559-447-4949",
            "fax_number": "559-447-4925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7130 N MILLBROOK AVE",
            "address_2": "SUITE 100",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203347",
            "telephone_number": "559-326-1238",
            "fax_number": "559-326-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTER",
        "first_name": "DAVID",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "G64875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ75882Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "PO1345510",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dkoster1657926@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2710 Dolbeer St",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955014736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.