Jeffrey William Kosman, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30020221 Issued in OH

Practice address

5319 Meadow LN CT
Elyria, OH 44035-1469

Phone

(440) 934-2626

Fax

(440) 934-2628

NPI assigned

Dec 5, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 18, 2013 through Nov 18, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Comprehensive Oral & Maxillofacial Surgery Center

  • Oral and Maxillofacial Surgery Clinic/Center
  • Sheffield Village, OH
  • NPI 1164854774
  NPD (past) Authorized official

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368144000000",
    "number": "1245398841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5319 MEADOW LN CT",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440351469",
            "telephone_number": "440-934-2626",
            "fax_number": "440-934-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5319 MEADOW LN CT",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440351469",
            "telephone_number": "440-934-2626",
            "fax_number": "440-934-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSMAN",
        "first_name": "JEFFREY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2013-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30020221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Jean Kohler, LMT
• Nichole Marie Kopp
• Daniel Kopronica
• Michael V. Koroly, D.O.
• Jason Kortis
• Athena Mae Koutsopoulos, LPN
• Amy M Kovalsky, RN, CNP
• Julie Kraker
• Larry J Krause, O.D.
• Amanda Kriesen, PHARMD

• Oral and Maxillofacial Surgery (Dentist) in Elyria, OH
• Providers in Elyria, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.