Individual provider Active NPI

Christina Kosachook

  • Family Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1164068383
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F346626-01 Issued in NY
Practice address
990 South Ave Ste 104
Rochester, NY 14620-2740
Phone
(585) 256-3000
Fax
(585) 256-3045
NPI assigned
Nov 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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 F346626-01 NY Primary

Addresses

Primary practice location

990 South Ave Ste 104
Rochester, NY 14620-2740

Mailing address

234 Bennington Hills CT
West Henrietta, NY 14586-9774
Phone (585) 290-3284

Other practice location 1

1417 Waterford Rd
Walworth, NY 14568-9556
Phone (585) 290-3284

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ckosa1@brockport.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F346626-01NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1574380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1164068383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 BENNINGTON HILLS CT",
            "city": "WEST HENRIETTA",
            "state": "NY",
            "postal_code": "145869774",
            "telephone_number": "585-290-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 SOUTH AVE STE 104",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202740",
            "telephone_number": "585-256-3000",
            "fax_number": "585-256-3045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1417 Waterford Rd",
            "address_purpose": "LOCATION",
            "city": "Walworth",
            "state": "NY",
            "postal_code": "145689556",
            "country_code": "US",
            "telephone_number": "585-290-3284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSACHOOK",
        "first_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-22",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F346626-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckosa1@brockport.edu",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "1417 Waterford Rd",
            "city": "Walworth",
            "state": "NY",
            "country_code": "US",
            "postal_code": "145689556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.