NPIMap

Individual provider Active NPI

Semyon Kostko, M.D.

  • Internal Medicine Physician
  • Rego Park, NY
National Provider Identifier
1467490896
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
234140-1 Issued in NY
Practice address
9932 66TH Rd Ste LP
Rego Park, NY 11374-4401
Phone
(718) 275-5200
NPI assigned
Jun 4, 2006
Last updated
Dec 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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 234140-1 NY Primary

Addresses

Primary practice location

9932 66TH Rd Ste LP
Rego Park, NY 11374-4401

Mailing address

9932 66TH Rd Ste LP
Rego Park, NY 11374-4401
Phone (718) 902-7737

Other identifiers 1

IdentifierTypeStateIssuer
02621089MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050106001063 NY Practitioner - Internal Medicine 5092763979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kostko Medical PLLCGroup PAC ID 2264750082, 3 clinicians

Practice addresses (Care Compare)

9876 Queens Blvd
Suite 1JK
Rego Park, NY 11374-4398
Phone (718) 459-8900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
42.44 of 100Reported as individual
Quality
20
Improvement activities
0
Cost
81.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
234140-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kostko Medical PLLC Internal Medicine CurrentSince Feb 25, 2015 Accepting new patients
Complete Medical Ny, PC Internal Medicine PastSince Mar 1, 2011 Accepting new patients
Bay Park One Medical, PC PastSince Aug 1, 2005 Accepting new patients
Starosta Medical PC Internal Medicine Past Accepting new patients
Health Care for All, NP in Adult Health, P.C. Past Accepting new patients

Locations

9876 Queens Blvd
Ste 1JK
Rego Park, NY 11374
Phone (718) 459-8900

9932 66th Rd
Ste Lp
Rego Park, NY 11374
Phone (718) 459-8900

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

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 9

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1467490896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9932 66TH RD STE LP",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744401",
            "telephone_number": "718-902-7737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9932 66TH RD STE LP",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744401",
            "telephone_number": "718-275-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTKO",
        "first_name": "SEMYON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "234140-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02621089",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.