Organization Active NPI

Daniel J. Cosgrove, M.D. Inc.

  • Urology Physician
  • Encino, CA
National Provider Identifier
1073900817
Registry record updated Apr 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A64348 Issued in CA
Legal business name
DANIEL J. COSGROVE, M.D. INC.
Practice address
16311 Ventura Blvd
Ste. 800
Encino, CA 91436-2124
Phone
(818) 906-0635
Fax
(818) 906-7303
NPI assigned
Apr 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2015

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

Authorized official

Name
Dr. Daniel Jeremy Cosgrove, MDNPI 1790766491
Title
Owner
Phone
(818) 906-0635

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X A64348 CA Primary

Addresses

Primary practice location

16311 Ventura Blvd
Ste. 800
Encino, CA 91436-2124

Mailing address

16311 Ventura Blvd
Ste. 800
Encino, CA 91436-2124
Phone (818) 906-0635

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150626000933 CA Part B Supplier - Clinic/Group Practice 1951613355 Receives reassigned benefits from 2 practitioners
Practice locations: Encino, CA

National Provider Directory

National Provider Directory

Locations

16311 Ventura Blvd
Ste 800
Encino, CA 91436
Phone (818) 788-7343

Interoperability endpoints

  • Direct secure messaging: danielcosgrove@djcmd.medalliesdirect.net
  • FHIR API: https://app.meldrx.com/api/fhir/uc05034_danieljcosgrove

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429488000000",
    "number": "1073900817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BLVD",
            "address_2": "STE. 800",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362124",
            "telephone_number": "818-906-0635",
            "fax_number": "818-906-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BLVD",
            "address_2": "STE. 800",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362124",
            "telephone_number": "818-906-0635",
            "fax_number": "818-906-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL J. COSGROVE, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-20",
        "last_updated": "2015-04-20",
        "status": "A",
        "authorized_official_last_name": "COSGROVE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "JEREMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-906-0635",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "A64348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.