Individual provider Active NPI

Debra E Koss, M.D.

  • Child & Adolescent Psychiatry Physician
  • Sparta, NJ
National Provider Identifier
1114044997
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
25MA06712500 Issued in NJ
Practice address
46 Main St
Sparta, NJ 07871-1935
Phone
(973) 726-4137
Fax
(973) 726-4138
NPI assigned
Mar 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 25MA06712500 NJ Primary

Addresses

Primary practice location

46 Main St
Sparta, NJ 07871-1935

Mailing address

PO Box 605
Sparta, NJ 07871-0605
Phone (973) 726-4137

Medicare participation

Medicare enrollment files
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA06712500NJMDChild & Adolescent Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114044997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 605",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078710605",
            "telephone_number": "973-726-4137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 MAIN ST",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078711935",
            "telephone_number": "973-726-4137",
            "fax_number": "973-726-4138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSS",
        "first_name": "DEBRA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "25MA06712500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, NJ

Sources for this page

Verify at the official NPI Registry.