Chris A Kosakowski, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G494990 Issued in CO

Practice address

1111 Sonoma Ave
Ste 112
Santa Rosa, CA 95405-4813

Phone

(707) 579-5520

Fax

(707) 579-8820

NPI assigned

Jun 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Sutter Trauma Assessment Team

  • Surgery Physician
  • Santa Rosa, CA
  • NPI 1811932619
  NPD (past) Authorized official

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1497782239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 SONOMA AVE",
            "address_2": "STE 112",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054813",
            "telephone_number": "707-579-5520",
            "fax_number": "707-579-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 SONOMA AVE",
            "address_2": "STE 112",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054813",
            "telephone_number": "707-579-5520",
            "fax_number": "707-579-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSAKOWSKI",
        "first_name": "CHRIS",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "CA",
            "license": "G494990",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "G494990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020052144",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS OF CALIFORNIA",
            "identifier": "00G494990",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G494990",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TraumaSurgeryAnnadel@sjhhandhmg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1162 Montgomery Dr Ste 3",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954054802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anne Kopp, PH.D.
• Pamela Susan Koppel, LCSW
• Alexandra Maria Korin, MD
• Keith Forrest Korver, M.D.
• Ashleigh E Korves, DPM
• Athena Kostick
• Talia Kostick
• Marena Koukis
• Deborah A Kovar, CRNA
• Michael Frederick Kozart

• Surgery Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.