Marya A Koza, MD
Individual provider Active NPI Pulmonary Disease Physician · Wrentham, MA
NPI 1477522571 · NPPES record last updated Dec 26, 2008
Key facts
- NPI
- 1477522571
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- License
- 209530 (MA)
- Practice address
- 844 Franklin St.
#4
Wrentham, MA 02093 - Phone
- (508) 384-2500
- Fax
- (508) 384-9410
- NPI assigned
- Mar 14, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Medical College of Pennsylvania, 1997
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Lifespan Physician Group of Massachusetts Inc
Practice addresses (Care Compare)
88 Washington St
Taunton, MA 02780-2465
Phone (508) 828-7000
Hospital & facility affiliations
- Brown University Health Morton Hospital
- Rhode Island Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070918000346 | MA | Practitioner - Anesthesiology |
0143314468 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209530 | MA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steward Medical Group, Inc | Specialist | Current |
Accepting new patients |
| Steward Medical Group, Inc | Specialist | Current |
Accepting new patients |
| Lifespan Physician Group of Massachusetts Inc | Current |
Accepting new patients | |
| Lifespan of Massachusetts - Taunton Inc | Pulmonary Disease | Past | Accepting new patients |
Locations
11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442
11 Nevins St
Brighton, MA 02135
Phone (617) 562-2782
100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157
531 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 991-2255
800 Washington St
Norwood, MA 02062
Phone (781) 278-6264
886 Washington St
Ste 2R
Norwood, MA 02062
88 Washington St
Taunton, MA 02780
Phone (508) 828-7000
9 Galen St
Watertown, MA 02472
Phone (617) 562-5413
40 Spring St
Watertown, MA 02472
Phone (617) 923-8433
844 Franklin St
Unit 4
Wrentham, MA 02093
Phone (508) 384-2500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 209530 | MA | |
| Pulmonary Disease Physician | 207RP1001X | 209530 | MA | Yes |
Addresses
Primary practice location
844 Franklin St.
#4
Wrentham, MA 02093
Mailing address
844 Franklin St.
#4
Wrentham, MA 02093
Phone (508) 384-2500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| J26470 | Other | MA | BCBS BLUE CROSS BLUE SHIELD |
| 2014661 | Medicaid | MA |
Other providers in Wrentham, MA
- Noemi Kahle
- Meghan Kelley
- King Philip Reg School District
- Kiera Kirkaldy
- Nikki Eschmann Kirsch
- Kristen Sullivan LMHC
- Felicia Kuplast
- William Peter Lafferty
- Robert H. Lambe
- Laura Lamplough
All providers in Wrentham, MA · Pulmonary Disease Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.