Individual provider Active NPI

Mark M. Kosker, D.C.

  • Chiropractor
  • Toluca Lake, CA
National Provider Identifier
1396892675
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC20264 Issued in CA
Practice address
10142 Riverside Dr
Toluca Lake, CA 91602-2532
Phone
(818) 505-9977
Fax
(818) 505-8495
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC20264 CA Primary

Addresses

Primary practice location

10142 Riverside Dr
Toluca Lake, CA 91602-2532

Mailing address

10142 Riverside Dr
Toluca Lake, CA 91602-2532
Phone (818) 505-9977

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101118000590 CA Practitioner - Chiropractic 4880880756 Practice locations: Toluca Lake, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10142 Riverside Dr
Toluca Lake, CA 91602-2532
Phone (808) 505-9977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20264CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396892675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10142 RIVERSIDE DR",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022532",
            "telephone_number": "818-505-9977",
            "fax_number": "818-505-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10142 RIVERSIDE DR",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022532",
            "telephone_number": "818-505-9977",
            "fax_number": "818-505-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSKER",
        "first_name": "MARK",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC20264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toluca Lake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.