Individual provider Active NPI

Bridget Elizabeth Kosilla, AUD

  • Audiologist
  • Brockton, MA
National Provider Identifier
1790343820
Registry record updated Jul 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
4767 Issued in MA
Practice address
35 Pearl St
Brockton, MA 02301-2866
Phone
(508) 588-8034
NPI assigned
Jun 4, 2019
Last updated
Jul 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 4767 MA Primary

Addresses

Primary practice location

35 Pearl St
Brockton, MA 02301-2866

Mailing address

35 Pearl St
Brockton, MA 02301-2866
Phone (617) 921-4139

Other practice location 1

188 Washington St
Plainville, MA 02762-1320
Phone (508) 699-1701

Other practice location 2

72 Washington St Ste 1600
Taunton, MA 02780-2430
Phone (508) 880-3460

Other practice location 3

825 Washington St Ste 310
Norwood, MA 02062-3481
Phone (781) 769-8910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190813002489 MA Practitioner - Qualified Audiologist 5092042010 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT Specialists, IncGroup PAC ID 0648353888, 20 clinicians

Practice addresses (Care Compare)

35 Pearl St
Suite 200
Brockton, MA 02301-2866
Phone (508) 588-8034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4767MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
ENT Norwood LLC CurrentSince Jun 27, 2019 Accepting new patients
ENT Specialists, Inc CurrentSince Jul 1, 2019 Accepting new patients

Locations

35 Pearl St
Brockton, MA 02301
Phone (508) 559-7237

35 Pearl St
Ste 100
Brockton, MA 02301
Phone (508) 588-8034

35 Pearl St
Ste 200
Brockton, MA 02301
Phone (508) 588-8034

825 Washington St
Ste 310
Norwood, MA 02062
Phone (508) 880-3460

188 Washington St
Plainville, MA 02762
Phone (508) 699-1701

72 Washington St
Ste 1600
Taunton, MA 02780
Phone (508) 880-3460

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HFADAA

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": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1790343820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012866",
            "telephone_number": "617-921-4139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012866",
            "telephone_number": "508-588-8034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "188 Washington St",
            "address_purpose": "LOCATION",
            "city": "Plainville",
            "state": "MA",
            "postal_code": "027621320",
            "country_code": "US",
            "telephone_number": "508-699-1701",
            "fax_number": "508-699-1706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "72 Washington St Ste 1600",
            "address_purpose": "LOCATION",
            "city": "Taunton",
            "state": "MA",
            "postal_code": "027802430",
            "country_code": "US",
            "telephone_number": "508-880-3460",
            "fax_number": "508-880-5335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "825 Washington St Ste 310",
            "address_purpose": "LOCATION",
            "city": "Norwood",
            "state": "MA",
            "postal_code": "020623481",
            "country_code": "US",
            "telephone_number": "781-769-8910",
            "fax_number": "781-255-9844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSILLA",
        "first_name": "BRIDGET",
        "middle_name": "ELIZABETH",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "4767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.