Individual provider Active NPI

Skylar Marie Kostick, PA-C

  • Physician Assistant
  • San Francisco, CA
National Provider Identifier
1164119574
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA68413 Issued in CA
Practice address
1975 4TH St # 4012
San Francisco, CA 94143-2351
Phone
(415) 353-1352
NPI assigned
Apr 18, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X OA006465 PA
Physician Assistant 363A00000X PA68413 CA Primary

Addresses

Primary practice location

1975 4TH St # 4012
San Francisco, CA 94143-2351

Mailing address

108 Cheswold CT
Chesterbrook, PA 19087-5628
Phone (610) 849-3082

Other practice location 1

7150 Hamilton Blvd Unit 400
Trexlertown, PA 18087-9734
Phone (610) 849-3082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240411002580 PA Practitioner - Physician Assistant 9436598356 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 Langhorne Newtown Rd
Langhorne, PA 19047-1201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
OA006465PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Health Access Network, Inc. CurrentSince Mar 3, 2024 Accepting new patients
Trinity Health Mid-Atlantic Medical Group CurrentSince Aug 14, 2025 Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Mar 3, 2024 Accepting new patients
Trinity Health Mid-Atlantic Medical Group CurrentSince Aug 14, 2025 Accepting new patients
Trinity Health Mid-Atlantic Medical Group Past Accepting new patients

Locations

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

1203 Langhorne Newtown Rd
Ste 225
Langhorne, PA 19047
Phone (215) 710-4490

1201 Langhorne Newtown Rd
Penndel, PA 19047
Phone (215) 710-2100

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

Interoperability endpoints

  • Direct secure messaging: skostick4609018@direct.trinity-health.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1164119574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 CHESWOLD CT",
            "city": "CHESTERBROOK",
            "state": "PA",
            "postal_code": "190875628",
            "telephone_number": "610-849-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 4TH ST # 4012",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432351",
            "telephone_number": "415-353-1352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7150 Hamilton Blvd Unit 400",
            "address_purpose": "LOCATION",
            "city": "Trexlertown",
            "state": "PA",
            "postal_code": "180879734",
            "country_code": "US",
            "telephone_number": "610-849-3082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSTICK",
        "first_name": "SKYLAR",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-18",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA006465",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA68413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.