Douglas Lee Kosmicki, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

24681 Issued in NE

Practice address

3515 Richmond Circle
Grand Island, NE 68803-4965

Phone

(308) 381-8636

Fax

(308) 381-8622

NPI assigned

Aug 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 12

Medicare fee-for-service enrollment

Enrolled in NE

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

Specialty

Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine

Education

University of Nebraska College of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CHI Health Clinic Specialty LLCGroup PAC ID 4789098443, 317 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI Health St. Francis Hospital, Grand Island, NE, CCN 280023
• Harlan County Health System Hospital, Alma, NE, CCN 281300
• Howard County Medical Center Hospital, St Paul, NE, CCN 281338
• Mary Lanning Healthcare Hospital, Hastings, NE, CCN 280032
• Kearney County Health Services Hospital Hospital, Minden, NE, CCN 281306

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• CHI Health Clinic Specialty, LLC

  • Hospitalist Physician
  • Lincoln, NE
  • NPI 1285138065

  NE

  Medicare reassignment Care Compare group NPD
• Nebraska Heart Institute PC

  • Cardiovascular Disease Physician
  • Lincoln, NE
  • NPI 1336125202

  Cardiovascular Disease

  NPD (past)
• North Platte Heart Institute PC

  • Ambulatory Surgical Clinic/Center
  • North Platte, NE
  • NPI 1306058425
  NPD (past)
• The Physician Network

  • Family Medicine Physician
  • Lincoln, NE
  • NPI 1437184652

  Internal Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Harlan County Health System

  • Critical Access Hospital
  • Alma, NE
  • NPI 1124035225

  Hospital

  Care Compare affiliation
• Howard County Medical Center

  • Critical Access Hospital
  • Saint Paul, NE
  • NPI 1922106152

  Hospital

  Care Compare affiliation
• Kearney Co Health Services

  • Critical Access Hospital
  • Minden, NE
  • NPI 1477585958

  Hospital

  Care Compare affiliation
• Saint Francis Medical Center

  • General Acute Care Hospital
  • Grand Island, NE
  • NPI 1982675955

  Hospital

  Care Compare affiliation
• The Mary Lanning Memorial Hospital Association

  • Clinical Medical Laboratory
  • Hastings, NE
  • NPI 1205442258

  Hospital

  Care Compare affiliation
• The Mary Lanning Memorial Hospital Association

  • Rural Acute Care Hospital
  • Hastings, NE
  • NPI 1831203488

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1295840130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7440 S 91ST ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269797",
            "telephone_number": "402-489-6555",
            "fax_number": "402-328-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 RICHMOND CIRCLE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034965",
            "telephone_number": "308-381-8636",
            "fax_number": "308-381-8622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSMICKI",
        "first_name": "DOUGLAS",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NE",
            "license": "24681",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NE",
            "license": "24681",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "24681",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026072500",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47070592302",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47070592305",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47070592313",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200567060A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026072400",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1202489",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026072300",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47070592300",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47070592301",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0202486",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47070592306",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Eric Kopcznski, FNP
• Abigail Korn
• Gina Marie Kosch
• Kimberly Elizabeth Kosch, COTA
• Amy Jo Kosmicki
• Allyssa Marie Kough
• Jessica Kounovsky-Soulek
• F Duane Kovarik, O.D.
• Susan Kowalski
• Charles Justin Kral, DPT

• All providers in Grand Island, NE
• Interventional Cardiology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; 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.

Verify at the official NPI Registry.