Individual provider Active NPI

Ashley Kosark

  • Specialist
  • Mastic Beach, NY
National Provider Identifier
1477817831
Registry record updated Jun 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1146372 Issued in NY
Practice address
7 Chestnut PL
Mastic Beach, NY 11951-7201
Phone
(631) 413-2215
NPI assigned
Jun 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1146372 NY Primary

Addresses

Primary practice location

7 Chestnut PL
Mastic Beach, NY 11951-7201

Mailing address

7 Chestnut PL
Mastic Beach, NY 11951-7201

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1146372NYMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341014400000",
    "number": "1477817831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CHESTNUT PL",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119517201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CHESTNUT PL",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119517201",
            "telephone_number": "631-413-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSARK",
        "first_name": "ASHLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-30",
        "last_updated": "2012-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1146372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mastic Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2012; 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.