DJ Kosterman OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

161 Issued in AK

Legal business name

DJ KOSTERMAN OD LLC

Practice address

11401 Old Glenn Hwy Ste 106B
Eagle River, AK 99577-7747

Phone

(907) 696-8733

Fax

(907) 696-8735

NPI assigned

Nov 27, 2007

Last updated

Sep 23, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dan J Kosterman, OD

Title

Sole Proprietor

Phone

(907) 696-3031

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Christi LB McWilliams, L.D.O.

  • Optician
  • Fairbanks, AK
  • NPI 1093920670
  NPD (past)
• Benjamin Alexander Ward, OPTICIAN

  • Optician
  • Anchorage, AK
  • NPI 1629255484
  NPD (past)

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1356523831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11401 OLD GLENN HWY STE 106B",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777747",
            "telephone_number": "907-696-8733",
            "fax_number": "907-696-8735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11401 OLD GLENN HWY STE 106B",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777747",
            "telephone_number": "907-696-8733",
            "fax_number": "907-696-8735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DJ KOSTERMAN OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-27",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "KOSTERMAN",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "907-696-3031",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OD11612",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Leigh Dietz-Lindner, RRT/CPFT
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• Discovery Living LLC
• Paula Danielle Dixey, MSN, RN, IBCLC
• Sarah Nicole Dompier
• Christine Donnelly, RBT
• Dopanine LLC
• Rachael Doyle
• Dr. Eldon Dekay, P.C. (Eagle River Orthodontics)

• Optometrist in Eagle River, AK
• Providers in Eagle River, AK by specialty
• Optometrist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; 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.