Individual provider Active NPI

Kenson Lacossiere, M.D.

  • Hospitalist Physician
  • Stuart, FL
National Provider Identifier
1255576286
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
ME114403 Issued in FL
Practice address
200 SE Hospital Ave
Stuart, FL 34994-2346
Phone
(772) 223-5618
Fax
(772) 288-5834
NPI assigned
Dec 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X ME114403 FL Primary
Internal Medicine Physician 207R00000X ME114403 FL

Addresses

Primary practice location

200 SE Hospital Ave
Stuart, FL 34994-2346

Mailing address

PO Box 417
Stuart, FL 34995-0417
Phone (772) 781-2799

Other identifiers 2

IdentifierTypeStateIssuer
14P0SOtherFLFLORIDA BLUE
007816400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130131000436 FL Practitioner - HospitalistPractitioner - Internal Medicine 6507902053 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin Memorial Medical Center IncGroup PAC ID 2961300611, 514 clinicians

Practice addresses (Care Compare)

200 SE Hospital Ave
Stuart, FL 34994-2346
Phone (772) 223-5665

Hospital & facility affiliations

  • Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME114403FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Florida, Inc Internal Medicine Current Accepting new patients
Martin Memorial Medical Center Inc CurrentSince Jan 1, 2025 Accepting new patients
Inpatient Consultants of Florida, Inc Internal Medicine CurrentSince Nov 12, 2015 Accepting new patients
Inpatient Consultants of Florida Inc Internal Medicine CurrentSince Nov 12, 2015 Accepting new patients
Memorial Family Practice Associates, LLC Past Accepting new patients
West Tennessee Medical Group Inc Internal Medicine Past Accepting new patients

Locations

4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561

2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

509 SE Riverside Dr
Ste 305
Stuart, FL 34994
Phone (772) 221-2003

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

2100 SE Salerno Rd
Stuart, FL 34997
Phone (772) 223-2300

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1255576286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349950417",
            "telephone_number": "772-781-2799",
            "fax_number": "772-781-2716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SE HOSPITAL AVE",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942346",
            "telephone_number": "772-223-5618",
            "fax_number": "772-288-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACOSSIERE",
        "first_name": "KENSON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-04",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME114403",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME114403",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "14P0S",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007816400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.