NPIMap

Individual provider Active NPI

Susan Koshy, ANP-BC

  • Adult Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1487908570
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
736187 Issued in TX
Practice address
3417 Gaston Ave Ste 935
Dallas, TX 75246-2036
Phone
(972) 870-0788
NPI assigned
Oct 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 736187 TX Primary

Addresses

Primary practice location

3417 Gaston Ave Ste 935
Dallas, TX 75246-2036

Mailing address

742 Hammond St
Coppell, TX 75019-4739
Phone (469) 451-5043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20121218000087 TX Practitioner - Nurse Practitioner 6800048927 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dallas County Hospital DistrictGroup PAC ID 8325934813, 597 clinicians

Practice addresses (Care Compare)

1800 N Britain Rd
Parkland Health
Irving, TX 75061-2630
Phone (214) 266-3000

5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone (214) 590-8006

Hospital & facility affiliations

  • Parkland Health & Hospital System Hospital, Dallas, TX, CCN 450015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Hospital District Adult Health Current Accepting new patients
Dallas County Hospital District CurrentSince Jun 23, 2021 Accepting new patients
Healthtexas Provider Network CurrentSince Aug 12, 2019 Accepting new patients
Dallas County Hospital District CurrentSince Jun 23, 2021 Accepting new patients
Healthtexas Provider Network CurrentSince Aug 12, 2019 Accepting new patients
Srilatha a. Reddy, M.D., P.a PastSince Oct 15, 2001 Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

3417 Gaston Ave
Ste 935
Dallas, TX 75246
Phone (469) 800-7680

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

1800 N Britain Rd
Irving, TX 75061
Phone (214) 266-3000

Interoperability endpoints

  • Direct secure messaging: skoshy147225@direct.phhs.org

Organizations & group practices 7

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 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1487908570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 HAMMOND ST",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750194739",
            "telephone_number": "469-451-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 GASTON AVE STE 935",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462036",
            "telephone_number": "972-870-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSHY",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-29",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "736187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.