Andrew Jerome Kosmowski, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

200100158 Issued in NC

Practice address

11050 Mt Belvedere Blvd
USA/Meddac/Credentials
Fort Drum, NY 13602-5004

Phone

(315) 772-4025

Fax

(315) 772-9498

NPI assigned

Nov 22, 2005

Last updated

Nov 8, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 GU, SC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555
  Medicare reassignment NPD
• Beaufort County Memorial Hospital

  dba Beaufort Memorial Emergency Medicine Physicians

  • Emergency Medicine Physician
  • Beaufort, SC
  • NPI 1871335018
  Medicare reassignment NPD
• Guam Memorial Hospital

  • General Acute Care Hospital
  • Oka Tamuning, GU
  • NPI 1366519027
  Medicare reassignment NPD
• Guam Memorial Hospital

  • Skilled Nursing Facility
  • Oka Tamuning, GU
  • NPI 1952479131
  NPD
• Alegent Creighton Health

  dba Alegent Creighton Health Bergan ED Services

  • Emergency Medicine Physician
  • Omaha, NE
  • NPI 1629343041
  NPD (past)
• Alexander Spring Emergency Physicians

  • Emergency Medicine Physician
  • Carlisle, PA
  • NPI 1386818029
  NPD (past)

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1629051727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 MT BELVEDERE BLVD",
            "address_2": "USA MEDDAC ATTN:CREDENTIALS",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025004",
            "telephone_number": "315-772-4025",
            "fax_number": "315-772-9498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 MT BELVEDERE BLVD",
            "address_2": "USA/MEDDAC/CREDENTIALS",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025004",
            "telephone_number": "315-772-4025",
            "fax_number": "315-772-9498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSMOWSKI",
        "first_name": "ANDREW",
        "middle_name": "JEROME",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "200100158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John David King
• Ian Kinkel, DPT
• Morgan Rae Kitto, LCSW
• Kyle Jay Klahs, DO
• Tess Klossner, LAT, ATC
• Benjamin Robert Kosteva, ATC
• Elizabeth Kramer
• Mark James Kriezis, MSW
• Stephen Gerald Kulka, DMD
• Sabrina Emerald Kunciw, M.D.

• Emergency Medicine Physician in Fort Drum, NY
• Providers in Fort Drum, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.