Individual provider Active NPI

Mark Kostin, M.D

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1790797322
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
209566 Issued in NY
Practice address
1655 E 13TH St
Brooklyn, NY 11229-1101
Phone
(718) 339-3100
Fax
(718) 339-3905
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 209566 NY Primary

Addresses

Primary practice location

1655 E 13TH St
Brooklyn, NY 11229-1101

Mailing address

200 W 58TH St
New York, NY 10019-1432
Phone (212) 307-1151

Other identifiers 1

IdentifierTypeStateIssuer
01902345MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040929000324 NY Practitioner - Internal MedicinePractitioner - Family Practice 7719956457 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1409 Gravesend Neck Rd
Brooklyn, NY 11229-4322
Phone (718) 332-5617

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upword Medical P.C. Internal Medicine Current Accepting new patients
Counter Point Medical P.C. Internal Medicine Current Accepting new patients
Rego Medical P.C. CurrentSince Jul 20, 2019 Accepting new patients
Suny Downstate Medical Center Past Accepting new patients

Locations

1409 Gravesend Neck Rd
Brooklyn, NY 11229
Phone (718) 332-7771

9614 63rd Dr
Rego Park, NY 11374
Phone (718) 896-0111

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790797322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W 58TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191432",
            "telephone_number": "212-307-1151",
            "fax_number": "212-307-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 E 13TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291101",
            "telephone_number": "718-339-3100",
            "fax_number": "718-339-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTIN",
        "first_name": "MARK",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "209566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01902345",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.