Individual provider Active NPI

Kylie Kosmacek, BCBA

  • Behavior Analyst
  • Omaha, NE
National Provider Identifier
1568947638
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-14-16557 Issued in NE
Practice address
909 S 76TH St
Omaha, NE 68114-4519
Phone
(402) 390-2100
NPI assigned
Sep 25, 2018
Last updated
Sep 25, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-14-16557 NE Primary

Addresses

Primary practice location

909 S 76TH St
Omaha, NE 68114-4519

Mailing address

522 S 130TH St
Omaha, NE 68154-2908
Phone (402) 320-6650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Maxwell Past Accepting new patients
Westside Community Schools PastSince Jan 26, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1568947638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 S 130TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542908",
            "telephone_number": "402-320-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 S 76TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144519",
            "telephone_number": "402-390-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSMACEK",
        "first_name": "KYLIE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NE",
            "license": "1-14-16557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.