Individual provider Active NPI

Mini Daniel Koshy, CRNP

  • Family Nurse Practitioner
  • Chalfont, PA
National Provider Identifier
1316552706
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP021863 Issued in PA
Practice address
207 Lincoln Cir
Chalfont, PA 18914-3583
Phone
(267) 269-0162
NPI assigned
Sep 11, 2020
Last updated
Sep 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP021863 PA Primary

Addresses

Primary practice location

207 Lincoln Cir
Chalfont, PA 18914-3583

Mailing address

207 Lincoln Cir
Chalfont, PA 18914-3583
Phone (267) 269-0162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210301000624 PA Practitioner - Nurse Practitioner 3072929967 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP021863PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MHP MD PLLC CurrentSince Apr 1, 2022 Accepting new patients
Mydoc Urgent Care CurrentSince May 20, 2022 Accepting new patients
Pennsylvania Urgent Care Centers, PLLC CurrentSince Apr 1, 2022 Accepting new patients
Mydoc Urgent Care PastSince May 20, 2022 Accepting new patients

Locations

780 N Krocks Rd
Ste 101B
Allentown, PA 18106
Phone (610) 365-3354

400 Fayette St
Ste 180
Conshohocken, PA 19428
Phone (484) 243-6622

48 E Ridge Pike
#A
Conshohocken, PA 19428
Phone (484) 243-6730

150 E Pennsylvania Ave
Ste 140
Downingtown, PA 19335
Phone (610) 518-1060

180 W Girard Ave
Ste 108
Philadelphia, PA 19123
Phone (267) 319-8047

3717 Chestnut St
Ste 202
Philadelphia, PA 19104
Phone (215) 800-1909

5708 Ridge Ave
Philadelphia, PA 19128
Phone (267) 440-7779

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1316552706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 LINCOLN CIR",
            "city": "CHALFONT",
            "state": "PA",
            "postal_code": "189143583",
            "telephone_number": "267-269-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 LINCOLN CIR",
            "city": "CHALFONT",
            "state": "PA",
            "postal_code": "189143583",
            "telephone_number": "267-269-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSHY",
        "first_name": "MINI",
        "middle_name": "DANIEL",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-11",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP021863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chalfont, PA

Sources for this page

Verify at the official NPI Registry.