Diane Korsower, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G37007 Issued in CA

Practice address

1 Harpst St
Student Health Center, Humboldt State University
Arcata, CA 95521-8222

Phone

(707) 826-3146

Fax

(707) 826-5042

NPI assigned

Dec 6, 2006

Sex

Female

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• California State Polytechnic University, Humboldt

  • Student Health Clinic/Center
  • Arcata, CA
  • NPI 1104991744
  NPD (past)
• Humboldt State University

  • Student Health Clinic/Center
  • Arcata, CA
  • NPI 1659793602
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710046008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1956 MAD RIVER RD",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955219691",
            "telephone_number": "707-826-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HARPST ST",
            "address_2": "STUDENT HEALTH CENTER, HUMBOLDT STATE UNIVERSITY",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955218222",
            "telephone_number": "707-826-3146",
            "fax_number": "707-826-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORSOWER",
        "first_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G37007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Boushek Kochendorfer, DDS
• Kate Jean Koelmel, RN
• Sara Koopman
• Stephanie M Kopacek
• Melissa Nichole Koren, BCBA
• Kimberly Kowalski, BCBA
• Masha Kozhevnikova, THERAPIST
• Ryan McVicar Kozisek, AMFT
• Jenny Suzanne Krause, R.D.
• Natsune Kubo, MSW, PPS-C, ASW

• Family Medicine Physician in Arcata, CA
• Providers in Arcata, 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 Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.