Individual provider Active NPI

Katherine Anne Kosiv, MD

  • Pediatric Cardiology Physician
  • New Haven, CT
National Provider Identifier
1295099497
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
63959 Issued in CT
Practice address
15 York St
New Haven, CT 06510-3221
Phone
(203) 785-2022
NPI assigned
Jul 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 63959 CT Primary
Pediatrics Physician 208000000X 125.061915 IL

Addresses

Primary practice location

15 York St
New Haven, CT 06510-3221

Mailing address

163 Woodlawn St
Hamden, CT 06517-1341
Phone (646) 234-5020

Other practice location 1

Osf Childrens Hospital Of Illinois
530 N.E. Glen Oak Avenue
Peoria, IL 61637-0001
Phone (309) 655-7171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20191003000403 CT Practitioner - Pediatric Medicine 3577884485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

1 Park St
New Haven, CT 06504-8901
Phone (203) 785-4081

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.061915ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Pediatrics CurrentSince Aug 18, 2019 Accepting new patients
Yale University CurrentSince Aug 18, 2019 Accepting new patients
Yale New Haven Hospital Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

15 York St
New Haven, CT 06510
Phone (203) 688-5303

1 Park St
North Haven, CT 06504
Phone (203) 785-4643

Interoperability endpoints

  • Direct secure messaging: kkosiv439710@direct.ynhh.org

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 and National Provider Directory roles.

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": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1295099497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 WOODLAWN ST",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065171341",
            "telephone_number": "646-234-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103221",
            "telephone_number": "203-785-2022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Osf Childrens Hospital Of Illinois",
            "address_2": "530 N.E. Glen Oak Avenue",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616370001",
            "country_code": "US",
            "telephone_number": "309-655-7171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSIV",
        "first_name": "KATHERINE",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-02",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CT",
            "license": "63959",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125.061915",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.