Individual provider Active NPI

Lauren Sophia Kosky

  • Speech-Language Pathologist
  • Dorchester, MA
National Provider Identifier
1639739287
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
105 Victory Rd
Dorchester, MA 02122-3518
Phone
(617) 371-3010
NPI assigned
Jun 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

105 Victory Rd
Dorchester, MA 02122-3518

Mailing address

105 Victory Rd
Dorchester, MA 02122-3518

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251117002030 MN Practitioner - Qualified Speech Language Pathologist 9234620394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4638 Victor Path
Suite 100
Hugo, MN 55038-4732

490 Hwy 96 W
Suite 300
Shoreview, MN 55126-1961

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10524MNMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kids Abilities, Inc. CurrentSince Oct 30, 2025 Accepting new patients
Kids Abilities, Inc CurrentSince Oct 30, 2025 Accepting new patients

Locations

4638 Victor Path
Ste 100
Hugo, MN 55038
Phone (651) 407-3777

490 Highway 96 W
Shoreview, MN 55126
Phone (651) 415-5490

490 Highway 96 W
Ste 300
Shoreview, MN 55126
Phone (651) 451-3016

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1639739287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 VICTORY RD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021223518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 VICTORY RD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021223518",
            "telephone_number": "617-371-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSKY",
        "first_name": "LAUREN",
        "middle_name": "SOPHIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.