NPIMap

Individual provider Active NPI

Zachary William Kostun, M.D.

  • Vascular Surgery Physician
  • Latham, NY
National Provider Identifier
1598022147
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
288677 Issued in NY
Practice address
6 Wellness Way Ste G02
Latham, NY 12110-2135
Phone
(518) 782-3900
Fax
(518) 782-3844
NPI assigned
Apr 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 288677 NY Primary

Addresses

Primary practice location

6 Wellness Way Ste G02
Latham, NY 12110-2135

Mailing address

6 Wellness Way Ste 201
Latham, NY 12110-2156
Phone (518) 782-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170613001738 NY Practitioner - Vascular Surgery 8426326588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
State University of New York at Buffalo School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Physicians PLLCGroup PAC ID 8022904473, 361 clinicians

Practice addresses (Care Compare)

123 Quaker Rd
Suite 106
Queensbury, NY 12804-1714
Phone (518) 640-6752

Hospital & facility affiliations

  • Eddy Visiting Nurse & Rehab Association Home health agency, Troy, NY, CCN 337203
  • Glens Falls Hospital Hospital, Glens Falls, NY, CCN 330191
  • Saratoga Hospital Hospital, Saratoga Springs, NY, CCN 330222
  • Nathan Littauer Hospital Hospital, Gloversville, NY, CCN 330276
  • St Marys Healthcare Hospital, Amsterdam, NY, CCN 330047

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
98.76
Improvement activities
40
Cost
76.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal21
Leg revascularization (restoring blood flow)29
Removal of tissue22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
288677NYMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PLLC CurrentSince Jul 17, 2017 Accepting new patients
Community Care Physicians, PC Vascular Surgery CurrentSince Apr 14, 2024 Accepting new patients
Community Care Physicians, PC Vascular Surgery Past Accepting new patients
Glens Falls Hospital Inc Past Accepting new patients

Locations

2520 Riverfront Ctr
Amsterdam, NY 12010
Phone (518) 782-3900

6 Wellness Way
Ste G02
Latham, NY 12110
Phone (518) 782-3900

6 Wellness Way
Ste G04
Latham, NY 12110
Phone (518) 785-5884

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

711 Troy Schenectady Rd
Ste 203
Latham, NY 12110
Phone (518) 782-3742

123 Quaker Rd
Ste 106
Queensbury, NY 12804
Phone (518) 640-6752

123 Quaker Rd
#106
Queensbury, NY 12804
Phone (518) 640-6752

123 Quaker Rd
Ste 104
Queensbury, NY 12804
Phone (518) 782-3799

Interoperability endpoints

  • Direct secure messaging: zacharykostun@ccp.allscriptsdirect.net

Organizations & group practices 4

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 25

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1598022147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE G02",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102135",
            "telephone_number": "518-782-3900",
            "fax_number": "518-782-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTUN",
        "first_name": "ZACHARY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-20",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "288677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.