Individual provider Active NPI

Laura Anne Cosenza, CNP

  • Adult Health Nurse Practitioner
  • Santa Rosa, CA
National Provider Identifier
1376852467
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP60053122 Issued in WA
Practice address
1162 Montgomery Dr
Santa Rosa, CA 95405-4802
Phone
(707) 890-4250
NPI assigned
Oct 7, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95027884 CA
Adult Health Nurse Practitioner 363LA2200X 05894-NP OH
Adult Health Nurse Practitioner 363LA2200X AP60053122 WA Primary

Addresses

Primary practice location

1162 Montgomery Dr
Santa Rosa, CA 95405-4802

Mailing address

904 7TH Ave
Seattle, WA 98104-1132
Phone (206) 860-5572

Other practice location 1

904 7th Ave
Seattle, WA 98104-1132
Phone (206) 860-5572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20231130003688 CA Practitioner - Nurse Practitioner 8426239179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1162 Montgomery Dr
Suite 200
Santa Rosa, CA 95405-4802
Phone (707) 890-4100

Hospital & facility affiliations

  • Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174
  • Adventist Health Ukiah Valley Hospital, Ukiah, CA, CCN 050301
  • Adventist Health Mendocino Coast Hospital, Fort Bragg, CA, CCN 051325
  • Healdsburg Hospital Hospital, Healdsburg, CA, CCN 051321
  • Adventist Health Howard Memorial Hospital, Willits, CA, CCN 051310

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95027884CAMDNurse Practitioner
05894-NPOHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Nov 1, 2023 Accepting new patients
Providence Medical Foundation CurrentSince Nov 1, 2023 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation Past Accepting new patients
James B. Nagle, M.D., Inc. Past Accepting new patients
Anoopa Patel LLC Past Accepting new patients
Annadel Medical Group, Inc PastSince Nov 19, 2023 Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

1162 Montgomery Dr
Ste 200
Santa Rosa, CA 95405
Phone (707) 890-4100

1162 Montgomery Dr
Ste 300
Santa Rosa, CA 95405
Phone (707) 890-4250

Organizations & group practices 7

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1376852467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 7TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041132",
            "telephone_number": "206-860-5572",
            "fax_number": "206-720-7418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1162 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054802",
            "telephone_number": "707-890-4250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "904 7th Ave",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981041132",
            "country_code": "US",
            "telephone_number": "206-860-5572",
            "fax_number": "206-720-7418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSENZA",
        "first_name": "LAURA",
        "middle_name": "ANNE",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95027884",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "05894-NP",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP60053122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.