Individual provider Active NPI

Cheryl Koscik, M.D.

  • Emergency Medicine Physician
  • Fort Thomas, KY
National Provider Identifier
1437389004
Registry record updated Nov 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
47759 Issued in KY
Practice address
85 N Grand Ave
Fort Thomas, KY 41075-1793
Phone
(859) 572-3617
Fax
(859) 572-2326
NPI assigned
Jul 17, 2009
Last updated
Nov 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 47759 KY Primary
Emergency Medicine Physician 207P00000X 4301094517 MI

Addresses

Primary practice location

85 N Grand Ave
Fort Thomas, KY 41075-1793

Mailing address

PO Box 18667
Erlanger, KY 41018-0667
Phone (859) 572-3617

Other identifiers 2

IdentifierTypeStateIssuer
201296990MedicaidIN
7100356160MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20181217002500 OH Practitioner - Emergency Medicine 5496906281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Albany Medical College of Union University, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-2200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Nov 28, 2018 Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

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.

Hospital & facility affiliations 1

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": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1437389004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18667",
            "city": "ERLANGER",
            "state": "KY",
            "postal_code": "410180667",
            "telephone_number": "859-572-3617",
            "fax_number": "859-572-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 N GRAND AVE",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "410751793",
            "telephone_number": "859-572-3617",
            "fax_number": "859-572-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSCIK",
        "first_name": "CHERYL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-17",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "47759",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301094517",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201296990",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100356160",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Thomas, KY

Sources for this page

Verify at the official NPI Registry.