Individual provider Active NPI

Adrian Cosmin, MD

  • Nephrology Physician
  • Louisville, KY
National Provider Identifier
1770543217
Registry record updated Sep 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
48058 Issued in KY
Practice address
716 W Broadway
Louisville, KY 40202-2216
Phone
(502) 595-7744
Fax
(502) 595-7007
NPI assigned
Mar 27, 2006
Last updated
Sep 11, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0062807 MD
Nephrology Physician 207RN0300X 48058 KY Primary

Addresses

Primary practice location

716 W Broadway
Louisville, KY 40202-2216

Mailing address

716 W Broadway
Louisville, KY 40202-2216
Phone (502) 595-7744

Other identifiers 1

IdentifierTypeStateIssuer
7100356810MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150601001389 KY Practitioner - NephrologyPractitioner - Internal Medicine 2860412004 Reassigns benefits to 1 organization
I20150730012959 IN Practitioner - NephrologyPractitioner - Internal Medicine 2860412004 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0062807MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Care Consultants, PSC Nephrology CurrentSince Mar 16, 2015 Accepting new patients
The Good Samaritan Hospital of Maryland, Inc. Past Accepting new patients
Medstar Good Samaritan Physicians LLC Past Accepting new patients

Locations

207 Sparks Ave
Ste 404
Jeffersonvlle, IN 47130
Phone (812) 218-3212

716 W Broadway
Louisville, KY 40202
Phone (502) 222-3449

Organizations & group practices 3

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441929600000",
    "number": "1770543217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022216",
            "telephone_number": "502-595-7744",
            "fax_number": "502-595-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022216",
            "telephone_number": "502-595-7744",
            "fax_number": "502-595-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSMIN",
        "first_name": "ADRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2015-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0062807",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "KY",
            "license": "48058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100356810",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.