Martha Socorro Kozub, APN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

71000129A Issued in IN

Practice address

5514 Hohman Ave.
Hammond, IN 46320

Phone

(219) 933-2018

Fax

(219) 933-2647

NPI assigned

May 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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 1

Specialty

Nurse Practitioner

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Healthnet IncGroup PAC ID 6305852344, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkozub3376@direct.franciscanalliance.org

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.

• Community Healthnet Inc

  • Community Health Clinic/Center
  • Gary, IN
  • NPI 1952332298
  Medicare reassignment Care Compare group NPD
• Community Healthnet Inc

  • Federally Qualified Health Center (FQHC)
  • Hammond, IN
  • NPI 1811650716
  NPD
• Community Healthnet Inc

  dba Morton High School

  • Federally Qualified Health Center (FQHC)
  • Hammond, IN
  • NPI 1164161469
  NPD (past)
• Community Healthnet Inc

  • Federally Qualified Health Center (FQHC)
  • Gary, IN
  • NPI 1649539933
  NPD (past)
• Community Healthnet Inc

  dba Community HealthNet@MLK

  • Federally Qualified Health Center (FQHC)
  • Gary, IN
  • NPI 1891262762
  NPD (past)
• Community Healthnet Inc

  • Federally Qualified Health Center (FQHC)
  • Merrillville, IN
  • NPI 1952660243
  NPD (past)
• Franciscan St. Margaret Health

  • Clinic/Center
  • Hammond, IN
  • NPI 1275911836
  NPD (past)

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1609098607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5514 HOHMAN AVE.",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "46320",
            "telephone_number": "219-933-2018",
            "fax_number": "219-933-2647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5530 Hohman Ave",
            "address_purpose": "LOCATION",
            "city": "Hammond",
            "state": "IN",
            "postal_code": "463201935",
            "country_code": "US",
            "telephone_number": "219-933-2018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZUB",
        "first_name": "MARTHA",
        "middle_name": "SOCORRO",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71000129A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkozub3376@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5530 Hohman Ave",
            "city": "Hammond",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463201935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• KND Development 59, LLC
• Joseph W Knight, DO
• Joseph Robert Kolanko, D.C.
• Karen Kolodziej
• Carly Renee Kowalski
• Kraunsta Family Healthcare LLC
• Dara Rae Kubiak, RDH,PHDH
• Victoria Kubin
• Labcorp Oklahoma, Inc.
• Cesar Mikels Labitan Jr., MD

• Adult Health Nurse Practitioner in Hammond, IN
• Providers in Hammond, IN by specialty
• Adult Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.