NPIMap

Organization Active NPI

Michael R. Cosenza, DPM, Inc.

  • Primary Podiatric Medicine Podiatrist
  • Ukiah, CA
National Provider Identifier
1316459787
Registry record updated Oct 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
E4380 Issued in CA
Legal business name
MICHAEL R. COSENZA, DPM, INC.
Practice address
238 Hospital Dr Ste B
Ukiah, CA 95482-4559
Phone
(707) 463-3668
Fax
(707) 463-3664
NPI assigned
Oct 25, 2017
Last updated
Oct 25, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2017

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

Authorized official

Name
Kellie Hawkins
Title
Credentialing Account Manager
Phone
(210) 298-6847

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X E4380 CA Primary

Addresses

Primary practice location

238 Hospital Dr Ste B
Ukiah, CA 95482-4559

Mailing address

238 Hospital Dr Ste B
Ukiah, CA 95482-4559
Phone (707) 463-3668

Other identifiers 1

IdentifierTypeStateIssuer
000E43800OtherCAMEDICARE

National Provider Directory

National Provider Directory

Locations

238 Hospital Dr
Ste B
Ukiah, CA 95482
Phone (707) 463-3668

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508889600000",
    "number": "1316459787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 HOSPITAL DR STE B",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824559",
            "telephone_number": "707-463-3668",
            "fax_number": "707-463-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 HOSPITAL DR STE B",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824559",
            "telephone_number": "707-463-3668",
            "fax_number": "707-463-3664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL R. COSENZA, DPM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-25",
        "last_updated": "2017-10-25",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_title_or_position": "CREDENTIALING ACCOUNT MANAGER",
        "authorized_official_telephone_number": "210-298-6847"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "CA",
            "license": "E4380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "000E43800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ukiah, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.