Active NPI
Christina Kosachook
- Family Nurse Practitioner
- Rochester, NY
National Provider Identifier
1164068383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F346626-01
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| F346626-01 | NY | MD | Family 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.