Individual provider Active NPI

Miriam Kosmoski, PA-C

  • Physician Assistant
  • Utica, NY
National Provider Identifier
1558765982
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
036063 Issued in NY
Practice address
601 State St Ste 200
Utica, NY 13502-4258
Phone
(315) 733-7598
NPI assigned
Oct 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0005873 MD
Physician Assistant 363A00000X MA057215 PA
Physician Assistant 363A00000X 036063 NY Primary

Addresses

Primary practice location

601 State St Ste 200
Utica, NY 13502-4258

Mailing address

328 Putnam St
Waterville, NY 13480-1213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151009001617 MD Practitioner - Physician Assistant 9537381900 Reassigns benefits to 2 organizations
I20201123001221 DC Practitioner - Physician Assistant 9537381900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

6701 N Charles St
Towson, MD 21204-6808
Phone (443) 849-2000

900 Caton Ave
Baltimore, MD 21229-5201
Phone (410) 368-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0005873MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central New York Cardiology, PC CurrentSince Aug 24, 2026 Accepting new patients
Cep America LLC CurrentSince Nov 11, 2023 Accepting new patients
Cep America LLC CurrentSince Nov 11, 2023 Accepting new patients
Medstar Urgent Care LLC CurrentSince Dec 1, 2020 Accepting new patients
Medstar Urgent Care LLC CurrentSince Dec 1, 2020 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

6701 N Charles St
Towson, MD 21204
Phone (443) 849-2000

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505

111 Hospital Dr
Utica, NY 13502
Phone (315) 801-8534

601 State St
Ste 200
Utica, NY 13502
Phone (315) 733-7598

Organizations & group practices 8

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 1

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": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1558765982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 PUTNAM ST",
            "city": "WATERVILLE",
            "state": "NY",
            "postal_code": "134801213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 STATE ST STE 200",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135024258",
            "telephone_number": "315-733-7598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSMOSKI",
        "first_name": "MIRIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-14",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0005873",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA057215",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "036063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.