Ryan Michael Kosek, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

14104 Issued in MN

Practice address

4300 Market Pte Dr Ste 100
Bloomington, MN 55435-5435

Phone

(952) 767-4574

NPI assigned

Oct 4, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Emergency Physicians Professional Association

  • Emergency Medicine Physician
  • Bloomington, MN
  • NPI 1801871934
  Medicare reassignment NPD
• Essentia Health Virginia, LLC

  • General Acute Care Hospital
  • Virginia, MN
  • NPI 1083617120
  Medicare reassignment NPD
• St Marys Medical Center

  • General Acute Care Hospital
  • Duluth, MN
  • NPI 1457393035
  Medicare reassignment
• St. Luke'S Hospital of Duluth

  • Rehabilitation Hospital Unit
  • Duluth, MN
  • NPI 1902845068
  Medicare reassignment
• St. Mary'S Hospital of Superior

  • Critical Access Hospital
  • Superior, WI
  • NPI 1083657886
  Medicare reassignment
• Emergency Physicians Professional Association

  • Urgent Care Clinic/Center
  • Golden Valley, MN
  • NPI 1750188488
  NPD
• St. Luke'S Hospital of Duluth

  • Pediatrics Physician
  • Duluth, MN
  • NPI 1023057338
  NPD
• St. Luke'S Hospital of Duluth

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Duluth, MN
  • NPI 1073480968
  NPD
• St. Mary'S Medical Center

  • Clinic/Center
  • Duluth, MN
  • NPI 1821835851
  NPD
• St. Mary'S Duluth Clinic Health System

  • Clinical Medical Laboratory
  • Superior, WI
  • NPI 1205866928
  NPD
• St. Mary'S Hospital of Superior

  • Critical Access Hospital Clinic/Center
  • Superior, WI
  • NPI 1588691588
  NPD

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1295200327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051950",
            "telephone_number": "218-786-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 MARKET PTE DR STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355435",
            "telephone_number": "952-767-4574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "181 W Meadow Dr Ste 400",
            "address_purpose": "LOCATION",
            "city": "Vail",
            "state": "CO",
            "postal_code": "816575058",
            "country_code": "US",
            "telephone_number": "970-476-1100",
            "fax_number": "970-672-0872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 E Boulder St",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809095533",
            "country_code": "US",
            "telephone_number": "719-365-6820",
            "fax_number": "719-365-6595",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "407 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558051950",
            "country_code": "US",
            "telephone_number": "218-786-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSEK",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-04",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7089-23",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0005591",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Kopicki
• Margaret Bao Van Kor, OTR/L
• Mohamud Ali Korow, NURSE PRACTITIONER
• Katelyn Korpi
• Kenneth Korte, M.D.
• Gary Kosel, M.D.
• Brea Kosman
• Sarah Kosteliz
• Ashalatha Kothakota
• Reed Allen Kotz, OTR/L

• Physician Assistant in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.