NPIMap

Individual provider Active NPI

Lynne M Kosmach, NP, CDE

  • Family Nurse Practitioner
  • Cloquet, MN
National Provider Identifier
1154318798
Registry record updated May 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R-1089282 Issued in MN
Practice address
927 Trettel LN
Cloquet, MN 55720-1345
Phone
(218) 879-1227
Fax
(218) 878-2136
NPI assigned
Sep 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2013

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 R-1089282 MN Primary

Addresses

Primary practice location

927 Trettel LN
Cloquet, MN 55720-1345

Mailing address

1802 Woodland Ave
Duluth, MN 55803-2547
Phone (218) 728-5375

Other identifiers 1

IdentifierTypeStateIssuer
911017800MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100921001073 MN Practitioner - Nurse Practitioner 2860517356 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

4212 Grand Ave
Duluth, MN 55807-2737
Phone (218) 786-3500

Hospital & facility affiliations

  • Essentia Health Duluth Hospital, Duluth, MN, CCN 240019
  • Essentia Health Virginia Hospital, Virginia, MN, CCN 240084
  • St Marys Hospital Superior Hospital, Superior, WI, CCN 521329
  • Essentia Health Deer River Hospital, Deer River, MN, CCN 241360

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1426MNMDMarriage & Family Therapist
R-1089282MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic LTD Current Accepting new patients
The Duluth Clinic, LTD CurrentSince May 7, 2018 Accepting new patients
Fond Du Lac Reservation Business Committee CurrentSince Sep 1, 1998 Accepting new patients
Fond Du Lac Reservation Business Committee CurrentSince Sep 1, 1998 Accepting new patients
The Duluth Clinic, LTD. CurrentSince May 7, 2018 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients

Locations

927 Trettel Ln
Cloquet, MN 55720
Phone (218) 879-1227

4212 Grand Ave
Duluth, MN 55807
Phone (218) 786-3500

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540

Organizations & group practices 6

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.

Hospital & facility affiliations 8

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369353600000",
    "number": "1154318798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 WOODLAND AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558032547",
            "telephone_number": "218-728-5375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 TRETTEL LN",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201345",
            "telephone_number": "218-879-1227",
            "fax_number": "218-878-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSMACH",
        "first_name": "LYNNE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "NP, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2013-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R-1089282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "911017800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cloquet, MN

Sources for this page

Verify at the official NPI Registry.