Talia Kostick

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12264897-1205 Issued in UT

Practice address

3569 Round Barn Cir Ste 200
Santa Rosa, CA 95403-5781

Phone

(707) 583-8800

NPI assigned

Mar 31, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tkostick627523@direct.ochin.org
• Direct secure messaging: tkostick406753@hisp.ehr.sutterhealth.org

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.

• Planned Parenthood Shasta Diablo Inc

  • Community Health Clinic/Center
  • Concord, CA
  • NPI 1982763090
  Medicare reassignment NPD
• Santa Rosa Community Health Centers

  dba Vista Campus

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1578631172
  Medicare reassignment NPD
• Planned Parenthood Shasta Diablo Inc

  dba Planned Parenthood Northern California

  • Community Health Clinic/Center
  • Chico, CA
  • NPI 1558420695
  NPD
• Planned Parenthood Shasta Diablo Inc

  dba Planned Parenthood Northern California

  • Clinical Medical Laboratory
  • San Rafael, CA
  • NPI 1750435244
  NPD
• Santa Rosa Community Health Centers

  dba Caritas Campus

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1467180430
  NPD
• Santa Rosa Community Health Centers

  dba Elsie Allen Campus

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1871651273
  NPD
• Planned Parenthood Shasta Diablo, Inc.

  dba Planned Parenthood Northern California

  • Community Health Clinic/Center
  • Santa Rosa, CA
  • NPI 1659671600
  NPD (past)
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1609925957
  NPD (past)
• Sutter West Bay Medical Foundation

  dba Sutter Pacific Medical Foundation

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1104852789
  NPD (past)

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

{
    "created_epoch": "1522454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1114423050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3569 ROUND BARN CIR STE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954035781",
            "telephone_number": "707-583-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3569 ROUND BARN CIR STE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954035781",
            "telephone_number": "707-583-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4745 S 3200 W",
            "address_purpose": "LOCATION",
            "city": "Taylorsville",
            "state": "UT",
            "postal_code": "841292822",
            "country_code": "US",
            "telephone_number": "801-964-6214",
            "fax_number": "801-982-9232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSTICK",
        "first_name": "TALIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-31",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "12264897-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Maria Korin, MD
• Keith Forrest Korver, M.D.
• Ashleigh E Korves, DPM
• Chris A Kosakowski, M.D.
• Athena Kostick
• Marena Koukis
• Deborah A Kovar, CRNA
• Michael Frederick Kozart
• Kellie Kozel, FNP
• Lindsay Kristine Krajecki

• Family Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.