Matthew Peter Koss, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

015867 Issued in NY

Practice address

475 Seaview Ave
Staten Island, NY 10305-3498

Phone

(718) 226-8851

NPI assigned

Sep 5, 2012

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1154670263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 CROMWELL AVE.",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10305",
            "telephone_number": "907-982-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053498",
            "telephone_number": "718-226-8851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSS",
        "first_name": "MATTHEW",
        "middle_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-05",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "015867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marianne Koshy, OTR/L
• Olga Kosichenko, PMHNP
• Rama Zwillenberg Koslowe, MD
• Stephanie Kosnik, M.S.SPED;SBL
• Dina Kospetas
• Igor Kostanyan, D.D.S.
• Polena A Kostyleva, PHARMD, RPH
• Karen Kosubevsky, MS CCC-SLP
• Dmitry Kotlyar, RN
• Allison Kotsonis

• Surgical Physician Assistant in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.