Active NPI
Kenneth R Koskella, M.D.
- Orthopaedic Surgery Physician
- Silverdale, WA
National Provider Identifier
1164495495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- MD00038111
- Practice address
- 4409 NW Anderson Hill Rd
Silverdale, WA 98383-6807 - Phone
- (360) 698-6630
- Fax
- (360) 698-7002
- NPI assigned
- Feb 8, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MD00038111 | WA | Primary |
Addresses
Primary practice location
4409 NW Anderson Hill Rd
Silverdale, WA 98383-6807
Mailing address
4409 NW Anderson Hill Rd
Silverdale, WA 98383-6807
Phone (360) 698-6630
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1115062 | Medicaid | WA | |
| 0199376 | Other | WA | LABOR AND INDUSTRIES |
| P00267733 | Other | WA | RAILROAD MEDICARE |
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
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kenneth R. Koskella, MD, Inc | Past | Accepting new patients | |
| Gregory P Duff, MD Inc PS | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Specialist
- Bremerton, WA
- NPI 1033204425
-
- Specialist
- Bremerton, WA
- NPI 1609961259
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197504000000",
"number": "1164495495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4409 NW ANDERSON HILL RD",
"city": "SILVERDALE",
"state": "WA",
"postal_code": "983836807",
"telephone_number": "360-698-6630",
"fax_number": "360-698-7002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4409 NW ANDERSON HILL RD",
"city": "SILVERDALE",
"state": "WA",
"postal_code": "983836807",
"telephone_number": "360-698-6630",
"fax_number": "360-698-7002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOSKELLA",
"first_name": "KENNETH",
"middle_name": "R",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-08",
"last_updated": "2007-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "WA",
"license": "MD00038111",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1115062",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES",
"identifier": "0199376",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00267733",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Silverdale, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.