Organization Active NPI

Dr. John F Kozlovsky MD PA

  • Ophthalmology Physician
  • San Antonio, TX
National Provider Identifier
1093949000
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
J0050 Issued in TX
Legal business name
DR. JOHN F KOZLOVSKY MD PA
Practice address
2929 Mossrock
Suite 104
San Antonio, TX 78230-5110
Phone
(210) 377-0350
Fax
(210) 377-2982
NPI assigned
May 5, 2009
Last updated
Oct 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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

Authorized official

Name
Mr. Lawrence Perry, M.A.
Title
Administrator
Phone
(210) 377-0350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X J0050 TX Primary

Addresses

Primary practice location

2929 Mossrock
Suite 104
San Antonio, TX 78230-5110

Mailing address

2929 Mossrock
Suite 104
San Antonio, TX 78230-5110
Phone (210) 377-0350

Other identifiers 1

IdentifierTypeStateIssuer
206264801MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090820000884 TX Part B Supplier - Clinic/Group Practice 1254485543 Receives reassigned benefits from 2 practitioners
Practice locations: San Antonio, TX; Live Oak, TX

National Provider Directory

National Provider Directory

Locations

1715 McCullough Ave
Ste 460
San Antonio, TX 78212
Phone (210) 225-7183

1900 N Main Ave
San Antonio, TX 78212
Phone (210) 226-3204

2929 Mossrock
Ste 206
San Antonio, TX 78230
Phone 2107364461152

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318377600000",
    "number": "1093949000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 MOSSROCK",
            "address_2": "SUITE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305110",
            "telephone_number": "210-377-0350",
            "fax_number": "210-377-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 MOSSROCK",
            "address_2": "SUITE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305110",
            "telephone_number": "210-377-0350",
            "fax_number": "210-377-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JOHN F KOZLOVSKY MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-05",
        "last_updated": "2011-10-12",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "210-377-0350",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "J0050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206264801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; 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.