Kurtis Kostan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

S4168 Issued in TX

Practice address

2210 Three Lakes Pkwy Ste 100
Tyler, TX 75703-0642

Phone

(903) 747-4050

Fax

(903) 747-4075

NPI assigned

Apr 16, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Internal Medicine

Education

University of Texas Medical Branch at Galveston, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Choice Homecare Home health agency, Tyler, TX, CCN 458261
• Enhabit Home Health Home health agency, Tyler, TX, CCN 459457
• Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
• Ut Health East Texas Henderson Hospital Hospital, Henderson, TX, CCN 450475
• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
• University of Texas Health Science Center at Tyler Hospital, Tyler, TX, CCN 450690
• Ut Health East Texas Rehabilitation Hospital Inpatient rehabilitation facility, Tyler, TX, CCN 453072

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkostan467336@ahs.direct-ci.com

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.

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment Care Compare group NPD
• Sound Inpatient Physicians of Texas I, Inc

  • Family Medicine Physician
  • Sugar Land, TX
  • NPI 1831424563

  Internal Medicine

  Medicare reassignment NPD
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD
• Sound Inpatient Physicians of Texas I, Inc

  • Hospitalist Physician
  • San Antonio, TX
  • NPI 1811321797

  Internal Medicine

  NPD
• Tyler Family Circle of Care

  • Community/Retail Pharmacy
  • Tyler, TX
  • NPI 1942011903
  NPD (past)

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

• Ahm Action Home Health, LP

  • Home Health Agency
  • Tyler, TX
  • NPI 1588644934
  Care Compare affiliation
• Henderson Hospital, LLC

  • General Acute Care Hospital
  • Henderson, TX
  • NPI 1326546797
  Care Compare affiliation
• Integrity Family Home Care LLC

  • Home Health Agency
  • Tyler, TX
  • NPI 1699009803
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation
• Rehabilitation Hospital, LLC

  • Rehabilitation Hospital
  • Tyler, TX
  • NPI 1174021695

  Inpatient rehabilitation facility

  Care Compare affiliation
• Tyler Regional Hospital LLC

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1407364847
  Care Compare affiliation
• University of Texas Health Science Center at Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1417941295
  Care Compare affiliation

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

{
    "created_epoch": "1429142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1134516172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 THREE LAKES PKWY STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030642",
            "telephone_number": "903-747-4050",
            "fax_number": "903-747-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 THREE LAKES PKWY STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030642",
            "telephone_number": "903-747-4050",
            "fax_number": "903-747-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTAN",
        "first_name": "KURTIS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-16",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S4168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Konieczny, PHARMD
• Lindsey Nance Koon, FNP-C
• Aleksandr Korniyenko, M.D.
• Rachel Koshy
• Vikki Kost, OT
• Chris Thomas Koster, RN
• Rajeshwari Koti, MS, MSC, CGC
• Paul R Kowalski, MD
• Laura Kay Kraft
• Susan Kramp

• Internal Medicine Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.