Individual provider Active NPI

Matthew Cosola, PA

  • Physician Assistant
  • New Hyde Park, NY
National Provider Identifier
1689484370
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
27005 76TH Ave
New Hyde Park, NY 11040-1402
Phone
(718) 470-7000
NPI assigned
Jan 13, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

27005 76TH Ave
New Hyde Park, NY 11040-1402

Mailing address

121 Strattford Rd
New Hyde Park, NY 11040-3535

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250513002621 NY Practitioner - Physician Assistant 4880112937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4000

27005 75TH Ave
New Hyde Park, NY 11040-1402

27005 76TH Ave GF
New Hyde Park, NY 11040-1402
Phone (718) 470-7501

Hospital & facility affiliations

  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Mar 24, 2025 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1736726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1689484370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 STRATTFORD RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110403535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "718-470-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSOLA",
        "first_name": "MATTHEW",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.