Individual provider Active NPI

Karen Costley, MD

  • Internal Medicine Physician
  • New City, NY
National Provider Identifier
1417935651
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
164004 Issued in NY
Practice address
345 N Main St
New City, NY 10956-4305
Phone
(845) 634-6500
Fax
(845) 634-9424
NPI assigned
Jan 6, 2006
Last updated
Dec 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 164004 NY Primary

Addresses

Primary practice location

345 N Main St
New City, NY 10956-4305

Mailing address

17 Squadron Blvd
Suite 400
New City, NY 10956-5214
Phone (845) 634-6500

Other identifiers 1

IdentifierTypeStateIssuer
01220144MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Rockland Past Accepting new patients

Organizations & group practices 1

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": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1417935651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SQUADRON BLVD",
            "address_2": "SUITE 400",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109565214",
            "telephone_number": "845-634-6500",
            "fax_number": "845-634-9424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 N MAIN ST",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109564305",
            "telephone_number": "845-634-6500",
            "fax_number": "845-634-9424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTLEY",
        "first_name": "KAREN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-06",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "164004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01220144",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; 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.