Organization Active NPI

George a Kozminski Physician PC

  • Internal Medicine Physician
  • New Hartford, NY
National Provider Identifier
1558909812
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GEORGE A KOZMINSKI PHYSICIAN PC
Practice address
1 Oxford Xing Ste 1
New Hartford, NY 13413-3200
Phone
(315) 507-4751
Fax
(315) 765-6056
NPI assigned
Dec 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Authorized official

Name
George A Kozminski, MDNPI 1669462511
Title
Owner
Phone
(315) 507-4751

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Addiction Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0401X

Addresses

Primary practice location

1 Oxford Xing Ste 1
New Hartford, NY 13413-3200

Mailing address

1 Oxford Xing Ste 1
New Hartford, NY 13413-3200
Phone (315) 507-4751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200414002669 NY Part B Supplier - Clinic/Group Practice 8921438003 Receives reassigned benefits from 1 practitioner
Practice locations: New Hartford, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576627200000",
    "number": "1558909812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OXFORD XING STE 1",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134133200",
            "telephone_number": "315-507-4751",
            "fax_number": "315-765-6056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 OXFORD XING STE 1",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134133200",
            "telephone_number": "315-507-4751",
            "fax_number": "315-765-6056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE A KOZMINSKI PHYSICIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-18",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A",
        "authorized_official_last_name": "KOZMINSKI",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-507-4751",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hartford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.