Individual provider Active NPI

Scot M Koski, PA

  • Physician Assistant
  • Marquette, MI
National Provider Identifier
1487006896
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1414 W Fair Ave Ste 190
Marquette, MI 49855-5406
Phone
(906) 225-1321
Fax
(906) 228-9371
NPI assigned
Jul 9, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1414 W Fair Ave Ste 190
Marquette, MI 49855-5406

Mailing address

1414 W Fair Ave Ste 190
Marquette, MI 49855-5406
Phone (906) 225-1321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20161003000314 MI Practitioner - Physician Assistant 0840587077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1414 W Fair Ave
Marquette, MI 49855-5406
Phone (906) 225-1321

580 W College Ave
Marquette, MI 49855-2736
Phone (906) 228-9440

901 Lakeshore Dr
Ishpeming, MI 49849-1367
Phone (906) 225-1321

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Surgery Associates of Marquette PC CurrentSince May 7, 2018 Accepting new patients

Locations

1414 W Fair Ave
Ste 190
Marquette, MI 49855
Phone (906) 225-1321

Organizations & group practices 2

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 3

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": "1468022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1487006896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE STE 190",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498555406",
            "telephone_number": "906-225-1321",
            "fax_number": "906-228-9371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE STE 190",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498555406",
            "telephone_number": "906-225-1321",
            "fax_number": "906-228-9371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSKI",
        "first_name": "SCOT",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-09",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.