Pavel Kosover, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

002617 Issued in CT

Practice address

3396 E Main St
Waterbury, CT 06705-3812

Phone

(203) 754-2161

NPI assigned

Apr 17, 2008

Last updated

Apr 17, 2008By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thomaston Physical Therapy, LLCGroup PAC ID 2264487701, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thomaston Physical Therapy, LLC

  • Physical Therapist
  • Thomaston, CT
  • NPI 1689865792
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1568636884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3396 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067053812",
            "telephone_number": "203-754-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3396 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067053812",
            "telephone_number": "203-754-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSOVER",
        "first_name": "PAVEL",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-17",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "002617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olga Konykhov, M.D.
• Elizabeth Korn, APRN, LMFT
• Mikail Jayden Koroma, MD
• Robert Scott Korwin, PH.D.
• Ashley Koskovich
• Yanina Kostina, M.D.
• Bhavani Kota, RPH
• Christina Koukopoulos
• Dimytra Kowaleski-Pham
• Meagan Kozhimala, MD

• Occupational Therapist in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Occupational Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.