Individual provider Active NPI

Raymond F Kostin, MD

  • Surgery Physician
  • Harrisburg, PA
National Provider Identifier
1760444087
Registry record updated Dec 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD031429L Issued in PA
Practice address
205 S Front St
4TH FL, Bma
Harrisburg, PA 17104-1619
Phone
(717) 231-8555
Fax
(717) 231-8568
NPI assigned
Apr 3, 2006
Last updated
Dec 15, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD031429L PA Primary

Addresses

Primary practice location

205 S Front St
4TH FL, Bma
Harrisburg, PA 17104-1619

Mailing address

409 S 2ND St
Suite 2F
Harrisburg, PA 17104-1612

Other identifiers 1

IdentifierTypeStateIssuer
000593965MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040812000048 PA Practitioner - General SurgeryPractitioner - Thoracic SurgeryPractitioner - Vascular Surgery 4688646326 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD031429LPAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Jul 1, 2004 Accepting new patients
Pinnacle Health Medical Services CurrentSince Jul 1, 2004 Accepting new patients
Pinnacle Health Medical Services Surgery Current Accepting new patients
Pinnacle Health Cardiovascular Institute Inc Surgery CurrentSince Jul 1, 2013 Accepting new patients

Locations

360 Alexander Spring Rd
Carlisle, PA 17015
Phone (717) 243-6557

205 S Front St
Fl 4
Harrisburg, PA 17104
Phone (717) 231-8555

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

205 S Front St
Harrisburg, PA 17104
Phone (717) 231-8360

2005 Technology Pkwy
Ste 300
Mechanicsburg, PA 17050
Phone (717) 782-4785

Organizations & group practices 4

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513296000000",
    "number": "1760444087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST",
            "address_2": "SUITE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S FRONT ST",
            "address_2": "4TH FL, BMA",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041619",
            "telephone_number": "717-231-8555",
            "fax_number": "717-231-8568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTIN",
        "first_name": "RAYMOND",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2017-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD031429L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000593965",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.