Michael M Koshak, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A36588 Issued in CA

Practice address

11631 Victory Blvd
101
North Hollywood, CA 91606-3572

Phone

(818) 764-8838

Fax

(818) 432-2238

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

No

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 CA

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

Specialty

General Practice

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (3 of 4)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Victory Physical Rehabilitation, Inc

  • Physical Medicine & Rehabilitation Physician
  • North Hollywood, CA
  • NPI 1033803168
  Medicare reassignment NPD Authorized official
• Choice Providers Medical Group Inc

  • Family Medicine Physician
  • Reseda, CA
  • NPI 1114947058
  Medicare reassignment NPD
• Dr. Loren Chen, MD Inc

  • Internal Medicine Physician
  • North Hollywood, CA
  • NPI 1790972081
  NPD

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1689680696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11631 VICTORY BLVD",
            "address_2": "#101",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063572",
            "telephone_number": "818-764-8838",
            "fax_number": "818-432-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11631 VICTORY BLVD",
            "address_2": "101",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063572",
            "telephone_number": "818-764-8838",
            "fax_number": "818-432-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSHAK",
        "first_name": "MICHAEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A36588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mina Kolta, RPH
• Joyce Kong
• Philip Ling-Fat Kong, PHARMD
• Arie Koren, RPT
• Ronald David Korn, MFT
• Eman Kotb
• Jordan Krebs, LMFT
• Wahak Krikorian
• Joshua Krippner
• Michelle Kubiak

• Family Medicine Physician in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; 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.
• 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.