Kyle Jeffrey Kostyun, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

010602021 Issued in FL

Practice address

399 Farmington Ave
3Rd Floor
Farmington, CT 06032-1936

Phone

(860) 284-0235

Fax

(860) 284-0221

NPI assigned

Jul 9, 2006

Last updated

Jul 18, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Connecticut Children's Specialty Group, Inc.

  • Ophthalmology Physician
  • Glastonbury, CT
  • NPI 1568056984
  NPD (past)

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500336000000",
    "number": "1710910013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 HOLLISTER DR",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060012934",
            "telephone_number": "813-416-5546",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 FARMINGTON AVE",
            "address_2": "3RD FLOOR",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321936",
            "telephone_number": "860-284-0235",
            "fax_number": "860-284-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTYUN",
        "first_name": "KYLE",
        "middle_name": "JEFFREY",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2017-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "010602021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATA MEMBER NUMBER",
            "identifier": "995586",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ekaterina Korytnikova, MD
• Jatupol Kositsawat, M.D.
• Lynn Kosowicz, MD
• Christina Lori Kosswig, D.C
• Jean Kostak, MS, RD
• Regina Kostyun, ATC
• Soor Nilesh Kothari, M.D.
• David Kotler, PA
• Jepkoech Jerop Kottutt, MD MPH
• Karin M Koval, PA

• Athletic Trainer in Farmington, CT
• Providers in Farmington, CT by specialty
• Athletic Trainer in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.