Alice Kay Koshevatskiy, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

16427 Issued in WI

Practice address

615 6TH St SE
Stanley, ND 58784-4444

Phone

(701) 628-8646

NPI assigned

Aug 31, 2023

Last updated

Aug 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, CA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Monterey Spine and Joint PCGroup PAC ID 0840295721, 75 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alice.koshevatskiy.p1@direct.msjhealth.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Monterey Spine & Joint PC

  • Orthopaedic Surgery Physician
  • Monterey, CA
  • NPI 1881620599
  Medicare reassignment Care Compare group NPD
• Kitsap Physical Therapy and Sports Clinic PS Inc

  • Physical Therapist
  • Silverdale, WA
  • NPI 1912902347
  Medicare reassignment NPD
• Multicare Health System

  dba Multicare Neurological Surgery

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• Kitsap Physical Therapy and Sports Clinic PS Inc

  • Durable Medical Equipment & Medical Supplies
  • Kingston, WA
  • NPI 1700466083

  Physical Therapist

  NPD
• Monterey Spine & Joint PC

  • Orthopaedic Surgery of the Spine Physician
  • Salinas, CA
  • NPI 1942885835
  NPD
• Multicare Health System

  dba MultiCare Health System - Inland NW Region

  • Family Medicine Physician
  • Spokane, WA
  • NPI 1386112977

  Physical Therapist

  NPD
• Multicare Health System

  dba MultiCare Deaconess Retail Pharmacy

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Montage Surgical Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Monterey, CA
  • NPI 1629864236
  NPD (past)

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1699550145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399",
            "city": "STANLEY",
            "state": "ND",
            "postal_code": "587840399",
            "fax_number": "701-628-3823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 6TH ST SE",
            "city": "STANLEY",
            "state": "ND",
            "postal_code": "587844444",
            "telephone_number": "701-628-8646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "284 W Greenfield Ave",
            "address_purpose": "LOCATION",
            "city": "Algoma",
            "state": "WI",
            "postal_code": "542011127",
            "country_code": "US",
            "telephone_number": "847-431-6353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSHEVATSKIY",
        "first_name": "ALICE",
        "middle_name": "KAY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-31",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "5779",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "CP022489T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070027454",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kurtis Todd Johnson, DC
• Pamella Jo Johnson
• Vonnie Jean Johnson, FNP
• Shelly L Kinney, LSW
• Matthew Klein
• Richard Paul Laksonen Jr., NP-C
• Cindy Sue Lancaster
• Kaitlyn D Lees, LSW
• Mark Kenneth Longmuir, MD
• Carly Lumley, RN

• Physical Therapist in Stanley, ND
• Providers in Stanley, ND by specialty
• Physical Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; 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.