Nicolas Alexander Kostelecky, MBBS

Primary specialty

Forensic Pathology PhysicianTaxonomy code 207ZF0201X

License

4301513424 Issued in MI

Practice address

300 Portage St
Kalamazoo, MI 49007-4929

Phone

(908) 666-5797

NPI assigned

Jun 27, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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

State licenses

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1073174140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PORTAGE ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490074929",
            "telephone_number": "908-666-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PORTAGE ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490074929",
            "telephone_number": "908-666-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTELECKY",
        "first_name": "NICOLAS",
        "middle_name": "ALEXANDER",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-27",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZN0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Neuropathology",
            "state": "IL",
            "license": "036.158663",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "2019022857",
            "primary": false
        },
        {
            "code": "207ZF0201X",
            "taxonomy_group": "",
            "desc": "Pathology, Forensic Pathology",
            "state": "MI",
            "license": "4301513424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose Korth-McDonnell
• Anne Kosanke, RN, BSN
• Santhosh Koshy, MD
• Channan Marie Kositzke, DNP-FNP-C
• Marie Koss-Ryan, SLP
• Rashmikant Kothari, M.D.
• Elaine Constance Kountanis, MD
• Rosemarie Kovac, OTR/L
• Dave Kovacs, M.D.
• Jacqueline Kowalke, DO

• Forensic Pathology Physician in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Forensic Pathology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; 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.