Individual provider Active NPI

Steli Pankova Kostov, FNP

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1083901268
Registry record updated Aug 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP4142 Issued in AZ
Practice address
4530 E Muirwood Dr
#105
Phoenix, AZ 85048-7639
Phone
(480) 961-2303
NPI assigned
Jul 7, 2011
Last updated
Aug 24, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP4142 AZ Primary

Addresses

Primary practice location

4530 E Muirwood Dr
#105
Phoenix, AZ 85048-7639

Mailing address

4530 E Muirwood Dr
#105
Phoenix, AZ 85048-7639
Phone (480) 961-2303

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111004000214 AZ Practitioner - Nurse Practitioner 4486826005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Internists of Ahwatukee PCGroup PAC ID 1759272958, 9 clinicians

Practice addresses (Care Compare)

4530 E Muirwood Dr
Suite 105
Phoenix, AZ 85048-7693
Phone (480) 961-2303

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP4142AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Internists of Ahwatukee, P.C. CurrentSince Sep 1, 2011 Accepting new patients

Locations

4530 E Muirwood Dr
Ste 105
Phoenix, AZ 85048
Phone (480) 961-2303

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1083901268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 E MUIRWOOD DR",
            "address_2": "#105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487639",
            "telephone_number": "480-961-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 E MUIRWOOD DR",
            "address_2": "#105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487639",
            "telephone_number": "480-961-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTOV",
        "first_name": "STELI",
        "middle_name": "PANKOVA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-07",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP4142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.