Individual provider Active NPI

Lyudmila A Kostiv, NP

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1447819271
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
344459 Issued in NY
Practice address
301 Prospect Ave
Syracuse, NY 13203-1807
Phone
(315) 726-9945
NPI assigned
Jun 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 344459 NY Primary

Addresses

Primary practice location

301 Prospect Ave
Syracuse, NY 13203-1807

Mailing address

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 726-9945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190917001266 NY Practitioner - Nurse Practitioner 1658600606 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Anesthesiology Medical Specialties PCGroup PAC ID 3375535396, 29 clinicians

Practice addresses (Care Compare)

6711 Towpath Rd
Suite 265
East Syracuse, NY 13057-9509
Phone (315) 703-3480

Hospital & facility affiliations

  • Oneida Health Hospital Hospital, Oneida, NY, CCN 330115

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
344459NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Hospital Health Center CurrentSince Oct 4, 2021 Accepting new patients
New York Anesthesiology Medical Specialties, PC CurrentSince Oct 28, 2023 Accepting new patients
St Joseph'S Hospital Health Center CurrentSince Oct 4, 2021 Accepting new patients
New York Anesthesiology Medical Specialties PC CurrentSince Oct 28, 2023 Accepting new patients
St Josephs Medical PC CurrentSince Aug 20, 2019 Accepting new patients
North Medical PC Current Accepting new patients

Locations

5417 W Genesee St
Ste 1
Camillus, NY 13031
Phone (315) 432-4900

6711 Towpath Rd
Ste 265
East Syracuse, NY 13057
Phone (315) 703-3480

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

5496 E Taft Rd
Ste B
Syracuse, NY 13212
Phone (315) 362-2060

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

5496 E Taft Rd
Syracuse, NY 13212
Phone (315) 552-6700

Organizations & group practices 6

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 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": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1447819271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-726-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-726-9945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTIV",
        "first_name": "LYUDMILA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.