Individual provider Active NPI

Laura Cosimi, MD

  • Pediatrics Physician
  • Lackland AFB, TX
National Provider Identifier
1336793850
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD2019-0242 Issued in NM
Practice address
1100 Wilford Hall Loop BLDG 45554
Lackland AFB, TX 78236-5638
Phone
(102) 292-6225
NPI assigned
Aug 1, 2019
Last updated
Sep 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X VL4795 SC
Pediatrics Physician 208000000X MD2019-0242 NM Primary

Addresses

Primary practice location

1100 Wilford Hall Loop BLDG 45554
Lackland AFB, TX 78236-5638

Mailing address

1100 Wilford Hall Loop BLDG 45554
Lackland AFB, TX 78236-5638
Phone (210) 292-6225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20240403003108 NM Practitioner - Pediatric Medicine 4688012131 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
VL4795SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Medical Centers of NM, Inc. CurrentSince Feb 15, 2024 Accepting new patients
McLeod Medical Centers of NM, Inc. CurrentSince Feb 15, 2024 Accepting new patients

Locations

11501 Montgomery Blvd NE
Albuquerque, NM 87111
Phone (505) 814-1333

1901 Juan Tabo Blvd NE
Albuquerque, NM 87112
Phone (505) 262-9200

4410 Irving Blvd NW
Albuquerque, NM 87114
Phone (505) 768-6123

7200 Montgomery Blvd NE
Albuquerque, NM 87109
Phone (505) 814-1995

12127 N State Highway 14
Ste 5
Cedar Crest, NM 87008
Phone (505) 281-2460

1851 Old US 66
Edgewood, NM 87015
Phone (505) 281-8463

1202 Main St NE
Ste A
Los Lunas, NM 87031
Phone (505) 565-0070

Interoperability endpoints

  • Direct secure messaging: laura.cosimi.1@27050.direct.athenahealth.com

Organizations & group practices 2

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": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1336793850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 45554",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 45554",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "102-292-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSIMI",
        "first_name": "LAURA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-01",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "VL4795",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2019-0242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackland AFB, TX

Sources for this page

Verify at the official NPI Registry.