Individual provider Active NPI

Koku Mawusi Gasinu

  • Cardiovascular Disease Physician
  • Bronx, NY
National Provider Identifier
1609945856
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
164779 Issued in NY
Practice address
2015 Grand Concourse
Bronx, NY 10453
Phone
(718) 299-7295
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 164779 NY Primary

Addresses

Primary practice location

2015 Grand Concourse
Bronx, NY 10453

Mailing address

3198 Grand Concourse FL 1
Bronx, NY 10458-1000
Phone (718) 618-0401

Other practice location 1

2115 Starling Avenue
First Floor
Bronx, NY 10462
Phone (718) 822-2810

Other practice location 2

2115 Starling Avenue
First Floor
Bronx, NY 10462
Phone (718) 822-2810

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050820000040 NY Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 1355371154 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Essen Medical Associates, PC CurrentSince Feb 12, 2019 Accepting new patients
Bronx Medical Practice P.C. CurrentSince Feb 12, 2019 Accepting new patients
Essen Medical Associates, PC CurrentSince Feb 12, 2019 Accepting new patients

Locations

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

2015 Grand Concourse
#13202
Bronx, NY 10453

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1609945856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3198 GRAND CONCOURSE FL 1",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104581000",
            "telephone_number": "718-618-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10453",
            "telephone_number": "718-299-7295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2115 Starling Avenue",
            "address_2": "First Floor",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "10462",
            "country_code": "US",
            "telephone_number": "718-822-2810",
            "fax_number": "718-822-8732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2115 Starling Avenue",
            "address_2": "First Floor",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "10462",
            "country_code": "US",
            "telephone_number": "718-822-2810",
            "fax_number": "718-822-8732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GASINU",
        "first_name": "KOKU",
        "middle_name": "MAWUSI",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "164779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.