Kenny Mikita Lacossiere, NURSE PRACTITIONER

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

304963-1 Issued in NY

Practice address

1275 York Ave
New York, NY 10065-6007

Phone

(212) 717-3028

Fax

(212) 717-3118

NPI assigned

Oct 15, 2008

Last updated

Oct 15, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 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

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: klacossiere38251@mskcc.direct-ci.com

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.

• Klein Medical Services

  • Anesthesiology Physician
  • Staten Island, NY
  • NPI 1609665207
  Medicare reassignment NPD
• Memorial Anesthesiology Group

  • Anesthesiology Physician
  • New York, NY
  • NPI 1467423020
  Medicare reassignment NPD
• Jersey Med Well

  dba Tri State Wound

  • Anesthesiology Physician
  • Manasquan, NJ
  • NPI 1356133409
  Medicare reassignment NPD
• Ira Klein PLLC

  • Anesthesiology Physician
  • Las Vegas, NV
  • NPI 1902776990
  NPD (past)

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224028800000",
    "number": "1336391853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 TURNER PL",
            "address_2": "APT 5W",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112183447",
            "telephone_number": "718-469-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-717-3028",
            "fax_number": "212-717-3118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACOSSIERE",
        "first_name": "KENNY",
        "middle_name": "MIKITA",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-15",
        "last_updated": "2008-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "304963-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Lackow, M.A.
• Juliette Rose Lackow, LCSW
• Rachel Stephanie Lacks, ED.M.
• Noah Laclair
• Jessica B Lacorte, AUD
• Nicole Lacoste, RPA-C
• Andrea Lacourciere, NP
• Eugenie Lacourt
• Mario Lacouture, MD
• Sheena Lacsina

• Adult Health Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; 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.