Individual provider Active NPI

Edward James Kosenski, D.C.

  • Chiropractor
  • Gaithersburg, MD
National Provider Identifier
1750426292
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01764 Issued in MD
Practice address
297 Muddy Branch Rd
Gaithersburg, MD 20878-3000
Phone
(301) 330-4443
NPI assigned
Feb 21, 2007
Last updated
Jul 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01764 MD Primary

Addresses

Primary practice location

297 Muddy Branch Rd
Gaithersburg, MD 20878-3000

Mailing address

6000 Laurel Bowie Rd 202
Bowie, MD 20715-4000
Phone (301) 352-3454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

418 E Diamond Ave
Gaithersburg, MD 20877-3018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01764MDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Johnson Chiropractic and Rehabilitation, P.a. PastSince Sep 17, 2011 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1750426292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 LAUREL BOWIE RD 202",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154000",
            "telephone_number": "301-352-3454",
            "fax_number": "301-352-0893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 MUDDY BRANCH RD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208783000",
            "telephone_number": "301-330-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSENSKI",
        "first_name": "EDWARD",
        "middle_name": "JAMES",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "01764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.