Charles S Kososky, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MA31978 Issued in NJ

Practice address

2 Capital Way Ste 456
Pennington, NJ 08534-2521

Phone

(609) 537-7300

NPI assigned

Jul 27, 2006

Last updated

Dec 20, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 14

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12833/brand/1/csg/1/fhir/r4

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.

• Capital Health Medical Group

  • Internal Medicine Physician
  • Trenton, NJ
  • NPI 1437516887

  Neurology

  Medicare reassignment NPD
• Capital Health Multispecialty Group

  • Surgery Physician
  • Trenton, NJ
  • NPI 1083072342

  Neurology

  Medicare reassignment NPD

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1245254531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CAPITAL WAY STE 456",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085342521",
            "telephone_number": "609-537-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CAPITAL WAY STE 456",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085342521",
            "telephone_number": "609-537-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSOSKY",
        "first_name": "CHARLES",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "MA31978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON BLUE SHIELD",
            "identifier": "223431049N",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2K6034",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD HMO",
            "identifier": "75872000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "0075872000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "066243",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1168107",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2941455",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEVON",
            "identifier": "223431049",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "66243",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1694405",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2739065",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "130025823",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1467471",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT BCBS",
            "identifier": "433274000",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charles.kososky.1@12833.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2 Capital Way Ste 456",
            "city": "Pennington",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "085342521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Deborah Ann Kimes
• David Kiviat
• Kerry J. Klett, PSY.D.
• Diana Kolman-Taddeo, M.D.
• Sriya Amruta Kosaraju, MD
• Justin Kotliar, MD
• Kaveh Kousari, M.D.
• Geoffrey Kozak, M.D.
• Ria Mulherkar Kraft, M.D.
• Lauren Kretzmer, MSW, LSW

• Neurology Physician in Pennington, NJ
• Providers in Pennington, NJ by specialty
• Neurology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.