Individual provider Active NPI

Tatiana E Kosyak, RPH, CPH

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Ormond Beach, FL
National Provider Identifier
1073990768
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
11667 Issued in CO
Practice address
38 Laurel Ridge Break
Ormond Beach, FL 32174
Phone
(386) 235-8760
NPI assigned
May 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 11667 CO Primary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PS21364 FL
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 051.036883 IL

Addresses

Primary practice location

38 Laurel Ridge Break
Ormond Beach, FL 32174

Mailing address

38 Laurel Ridge Break
Ormond Beach, FL 32174
Phone (386) 235-8760

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
11667COMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
PS21364FLMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
051.036883ILMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kosyak Consulting Pharmacist Clinician (PHC)/ Clinical Pharmacy Specialist CurrentSince Aug 11, 2019 Accepting new patients

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": "1430438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1073990768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 LAUREL RIDGE BREAK",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "32174",
            "telephone_number": "386-235-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 LAUREL RIDGE BREAK",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "32174",
            "telephone_number": "386-235-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSYAK",
        "first_name": "TATIANA",
        "middle_name": "E",
        "credential": "RPH, CPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-01",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CO",
            "license": "11667",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "FL",
            "license": "PS21364",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "IL",
            "license": "051.036883",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; 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.