Active NPI
Emma Colette Koesters, MD
- Plastic and Reconstructive Surgery Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 036.160267
- Practice address
- 5841 S Maryland Ave RM J461
Chicago, IL 60637-1443 - Phone
- (323) 442-7903
- NPI assigned
- Mar 23, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 036.160267 | IL | Primary |
Addresses
Primary practice location
5841 S Maryland Ave RM J461
Chicago, IL 60637-1443
Mailing address
150 Harvester Dr Ste 300
Burr Ridge, IL 60527-5965
Other names 1
- Emma David Vartanian
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Plastic and Reconstructive Surgery
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1450 San Pablo St
Los Angeles, CA 90033-4500
1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8444
1516 San Pablo St
Los Angeles, CA 90033-5313
Phone (800) 872-2273
1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273
1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273
1808 Verdugo Blvd
Suite 209
Glendale, CA 91208-1413
Phone (818) 236-4540
1812 Verdugo Blvd
Glendale, CA 91208-1407
Phone (818) 790-7100
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Mastectomy | 31 |
| Melanoma (skin cancer) excision | 23 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.160267 | IL | MD | Plastic and Reconstructive Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Usc Care Medical Group, Inc | Current | Accepting new patients | |
| Usc Care Medical Group, Inc | Current | Accepting new patients | |
| Usc University Hospital, Inc. | Past | Accepting new patients | |
| Usc Verdugo Hills Hospital, LLC | Past | Accepting new patients |
Locations
420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647
1808 Verdugo Blvd
Ste 209
Glendale, CA 91208
Phone (818) 949-4494
1200 N State St
Ste A7D
Los Angeles, CA 90089
Phone (323) 409-5555
1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849
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.
-
- General Practice Physician
- Los Angeles, CA
- NPI 1902846306
-
dba Fair Oaks Clinic
- Durable Medical Equipment & Medical Supplies
- Pasadena, CA
- NPI 1427937390
-
dba USC Hospital
- Psychiatric Hospital Unit
- Los Angeles, CA
- NPI 1790718500
-
dba Verdugo Hills Hospital
- General Acute Care Hospital
- Glendale, CA
- NPI 1265875207
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Keck Hospital of USC
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1013514199
-
dba USC Kenneth Norris Jr. Hospital
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1417554528
-
- General Acute Care Hospital
- Glendale, CA
- NPI 1033716147
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656633600000",
"number": "1295197796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 HARVESTER DR STE 300",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605275965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5841 S MARYLAND AVE RM J461",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371443",
"telephone_number": "323-442-7903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOESTERS",
"first_name": "EMMA",
"middle_name": "COLETTE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-23",
"last_updated": "2022-07-01",
"certification_date": "2022-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "IL",
"license": "036.160267",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "EMMA",
"last_name": "VARTANIAN",
"middle_name": "DAVID",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.