Individual provider Active NPI

Patricia A. Koski, N.P

  • Gerontology Nurse Practitioner
  • Leominister, MA
National Provider Identifier
1710073960
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
136954 Issued in MA
Practice address
48 Nelson Street
Leominister, MA 01453
Phone
(978) 227-5386
Fax
(978) 227-5712
NPI assigned
Oct 5, 2006
Last updated
Jun 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 035649-23-05 NH
Gerontology Nurse Practitioner 363LG0600X 136954 MA Primary

Addresses

Primary practice location

48 Nelson Street
Leominister, MA 01453

Mailing address

48 Nelson Street
Leominister, MA 01453
Phone (978) 227-5386

Other identifiers 1

IdentifierTypeStateIssuer
797779OtherNHMVP HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050627000244 MA Practitioner - Nurse Practitioner 2668417049 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heywood Medical Group Inc.Group PAC ID 6901882836, 111 clinicians

Practice addresses (Care Compare)

250 Green St
Gardner, MA 01440-1396
Phone (978) 630-6460

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
136954MAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Heywood Memorial Hospital CurrentSince Jan 1, 2022 Accepting new patients
Athol Memorial Hospital Incorporated CurrentSince Jan 1, 2022 Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Jan 1, 2022 Accepting new patients
Heywood Medical Group Inc. CurrentSince Jan 1, 2022 Accepting new patients
Medoptions of Massachusetts LLC Gerontology PastSince Oct 1, 1994 Accepting new patients
Accountable Care Practice Services PC PastSince Sep 1, 2012 Accepting new patients
Accountable Care Clinical Services PC PastSince Sep 1, 2012 Accepting new patients

Locations

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

250 Green St
Gardner, MA 01440
Phone (978) 630-5050

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1710073960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 NELSON STREET",
            "city": "LEOMINISTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-227-5386",
            "fax_number": "978-227-5712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 NELSON STREET",
            "city": "LEOMINISTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-227-5386",
            "fax_number": "978-227-5712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSKI",
        "first_name": "PATRICIA",
        "middle_name": "A.",
        "credential": "N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NH",
            "license": "035649-23-05",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "136954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTHCARE",
            "identifier": "797779",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominister, MA

Sources for this page

Verify at the official NPI Registry.