Active NPI
Bobbi Lee Kostinec, M.D.
- Family Medicine Physician
- Plymouth, MN
National Provider Identifier
1740421809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 40037
- Practice address
- 3555 Plymouth Blvd
Suite 218
Plymouth, MN 55447-1389 - Phone
- (763) 694-7000
- NPI assigned
- Mar 18, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 40037 | MN | Primary |
Addresses
Primary practice location
3555 Plymouth Blvd
Suite 218
Plymouth, MN 55447-1389
Mailing address
3555 Plymouth Blvd
Suite 218
Plymouth, MN 55447-1389
Phone (763) 694-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40037 | MN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237334400000",
"number": "1740421809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3555 PLYMOUTH BLVD",
"address_2": "SUITE 218",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554471389",
"telephone_number": "763-694-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3555 PLYMOUTH BLVD",
"address_2": "SUITE 218",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554471389",
"telephone_number": "763-694-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOSTINEC",
"first_name": "BOBBI",
"middle_name": "LEE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-18",
"last_updated": "2009-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "40037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.