Individual provider Active NPI

Agnieszka Kokoszka, MD

  • Clinical Neurophysiology Physician
  • New York, NY
National Provider Identifier
1326206285
Registry record updated Jan 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
233258-1 Issued in NY
Practice address
108 W 39TH St
Suite 1601
New York, NY 10018-3614
Phone
(646) 661-4117
Fax
(646) 661-2112
NPI assigned
May 28, 2008
Last updated
Jan 18, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X 233258-1 NY Primary

Addresses

Primary practice location

108 W 39TH St
Suite 1601
New York, NY 10018-3614

Mailing address

108 W 39TH St
Suite 1601
New York, NY 10018-3614
Phone (646) 661-4117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20080912000240 NY Practitioner - Neurology 7214003409 Reassigns benefits to 4 organizations
Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
State University of New York at Stony Brook, School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

314 W 14TH St
FL 6
New York, NY 10014-5002
Phone (212) 523-6521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
233258-1NYMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Era Diagnostics Inc CurrentSince Apr 1, 2021 Accepting new patients
New York Neurology Associates, P.C. CurrentSince Jan 1, 2014 Accepting new patients
Medalliance Medical Health Services Inc CurrentSince Jul 26, 2019 Accepting new patients
Salutem Diagnostics LLC CurrentSince Jun 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Audrey Halpern MD PC PastSince May 23, 2010 Accepting new patients
Slrhc Faculty Practice Past Accepting new patients
St Lukes Roosevelt Community Care Past Accepting new patients
Department of Neurology Professional Services Group/Slrhc Past Accepting new patients

Locations

625 E Fordham Rd
Bronx, NY 10458
Phone (718) 409-3433

3858 Nostrand Ave
Ste 201
Brooklyn, NY 11235

2965 Long Beach Rd
Oceanside, NY 11572
Phone (516) 593-8953

Organizations & group practices 11

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": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453075200000",
    "number": "1326206285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W 39TH ST",
            "address_2": "SUITE 1601",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100183614",
            "telephone_number": "646-661-4117",
            "fax_number": "646-661-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W 39TH ST",
            "address_2": "SUITE 1601",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100183614",
            "telephone_number": "646-661-4117",
            "fax_number": "646-661-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOKOSZKA",
        "first_name": "AGNIESZKA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2016-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NY",
            "license": "233258-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.