Individual provider Active NPI

Brian David Kossak, M.D.

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Manchester, NH
National Provider Identifier
1164459368
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X
License
8711 Issued in NH
Practice address
87 McGregor St
Dartmouth Hitchcock - Child Neurology
Manchester, NH 03102-3765
Phone
(603) 695-2500
Fax
(603) 695-2960
NPI assigned
Jun 26, 2006
Last updated
Jun 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X 8711 NH
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 8711 NH
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 213688 MA
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 8711 NH Primary

Addresses

Primary practice location

87 McGregor St
Dartmouth Hitchcock - Child Neurology
Manchester, NH 03102-3765

Mailing address

87 McGregor St
Dartmouth Hitchcock - Child Neurology
Manchester, NH 03102-3765
Phone (603) 695-2500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051107000573 NH Practitioner - Sleep MedicinePractitioner - Neurology 7911925144 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sleep MedicineAlso: Neurology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Foundation Medical Partners IncGroup PAC ID 9436140456, 313 clinicians

Practice addresses (Care Compare)

10 Jones Rd
Milford, NH 03055-3100
Phone (603) 672-7600

280 Main St
Nashua, NH 03060-2919
Phone (603) 577-2062

29 Northwest Blvd
Nashua, NH 03063-4068
Phone (603) 402-2070

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
213688MAMDNeurology with Special Qualifications in Child Neurology Physician
8711NHMDSleep Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation Medical Partners Inc CurrentSince Jun 28, 2021 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Jun 26, 1992 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Jun 26, 1992 Accepting new patients
Foundation Medical Partners Inc. CurrentSince Jun 28, 2021 Accepting new patients

Locations

25 S River Rd
Bedford, NH 03110
Phone (603) 626-4392

253 Pleasant St
Concord, NH 03301
Phone (603) 226-2200

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

275 Mammoth Rd
Ste 1
Manchester, NH 03109
Phone (603) 663-3222

87 McGregor St
Manchester, NH 03102
Phone (603) 629-1828

10 Jones Rd
Milford, NH 03055
Phone (603) 672-7600

22 Cotton Rd
Nashua, NH 03063
Phone (603) 899-6147

280 Main St
Ste 441
Nashua, NH 03060
Phone (603) 577-3061

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1164459368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 MCGREGOR ST",
            "address_2": "DARTMOUTH HITCHCOCK - CHILD NEUROLOGY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031023765",
            "telephone_number": "603-695-2500",
            "fax_number": "603-695-2960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 MCGREGOR ST",
            "address_2": "DARTMOUTH HITCHCOCK - CHILD NEUROLOGY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031023765",
            "telephone_number": "603-695-2500",
            "fax_number": "603-695-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSSAK",
        "first_name": "BRIAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "NH",
            "license": "8711",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NH",
            "license": "8711",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MA",
            "license": "213688",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "NH",
            "license": "8711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.