Tomasz A Kosierkiewicz X, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

036104826 Issued in IL

Practice address

2605 Main St
Mount Vernon, IL 62864-2372

Phone

(618) 242-7350

NPI assigned

Nov 4, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Neurology

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Regional HLTH Center Hospital, Mount Vernon, IL, CCN 140046
• SSM Health St Mary'S Hospital -Centralia Hospital, Centralia, IL, CCN 140034
• Clay County Hospital Hospital, Flora, IL, CCN 141351
• Washington County Hospital Hospital, Nashville, IL, CCN 141308
• Deaconess Illinois Crossroads Hospital, Mount Vernon, IL, CCN 140294

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mt Vernon Neurology, S.C.

  • Neurology Physician
  • Mount Vernon, IL
  • NPI 1720079015
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• County of Clay

  • Critical Access Hospital
  • Flora, IL
  • NPI 1184655136
  Care Compare affiliation
• Deaconess Illinois Crossroads Inc

  • General Acute Care Hospital
  • Mount Vernon, IL
  • NPI 1124745807
  Care Compare affiliation
• Good Samaritan Regional Health Center

  • General Acute Care Hospital
  • Mount Vernon, IL
  • NPI 1609897339
  Care Compare affiliation
• St Mary'S Hospital, Centralia, Illinois

  • General Acute Care Hospital
  • Centralia, IL
  • NPI 1083617245
  Care Compare affiliation
• Washington County Hospital District

  • Rural Health Clinic/Center
  • Nashville, IL
  • NPI 1316555816

  Hospital

  Care Compare affiliation
• Washington County Hospital District

  • Critical Access Hospital
  • Nashville, IL
  • NPI 1659321560
  Care Compare affiliation

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1487645776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2277",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628640044",
            "telephone_number": "618-242-7350",
            "fax_number": "618-242-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 MAIN ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642372",
            "telephone_number": "618-242-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSIERKIEWICZ",
        "first_name": "TOMASZ",
        "middle_name": "A",
        "name_suffix": "X",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036104826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "463609",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "04130321",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "130024619",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0361048261",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "078159",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David R Knowles, MD
• Heather Diann Knowles, APN-BC ACNP
• Erika Knox, OTR
• Victoria Koch, APRN
• Lisa B Korzenewski, R.N.
• Don A Kovalsky, M.D.
• Kroger Limited Partnership I
• Ashwath Senthil Kumar, MD
• Lacey L Laird, MHP
• Noelle Lamacchia, MHP

• Neurology Physician in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.