Individual provider Active NPI

Emma Kostoff, MH, MPH

  • Student in an Organized Health Care Education/Training Program
  • Middletown, CT
National Provider Identifier
1669314951
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
90 S Main St
Middletown, CT 06457-3649
Phone
(860) 358-6300
NPI assigned
Apr 7, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

90 S Main St
Middletown, CT 06457-3649

Mailing address

90 S Main St Ste 201
Middletown, CT 06457-3649
Phone (860) 358-6305

Other practice location 1

13 High St
Portland, CT 06480-1616
Phone (860) 358-7100

Other practice location 2

42 E High St Ste 205
East Hampton, CT 06424-1056
Phone (860) 358-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20260609002622 CT Order and Referring Only - Family PracticePractitioner - Family Practice 0446721583

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1775520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1669314951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 S MAIN ST STE 201",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573649",
            "telephone_number": "860-358-6305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 S MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573649",
            "telephone_number": "860-358-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13 High St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "CT",
            "postal_code": "064801616",
            "country_code": "US",
            "telephone_number": "860-358-7100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "42 E High St Ste 205",
            "address_purpose": "LOCATION",
            "city": "East Hampton",
            "state": "CT",
            "postal_code": "064241056",
            "country_code": "US",
            "telephone_number": "860-358-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSTOFF",
        "first_name": "EMMA",
        "name_prefix": "Dr.",
        "credential": "MH, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-07",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.