Active NPI
Mark Kostin, M.D
- Internal Medicine Physician
- Brooklyn, NY
National Provider Identifier
1790797322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 209566
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01902345 | Medicaid | NY |
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
Enrollment records 1
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
| Organization | Specialty | Status | New 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. | Current | 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.
-
- Primary Care Clinic/Center
- Brooklyn, NY
- NPI 1861602633
-
- Internal Medicine Physician
- Rego Park, NY
- NPI 1467072983
-
- Internal Medicine Physician
- Woodhaven, NY
- NPI 1558904045
-
- Emergency Medicine Physician
- Brooklyn, NY
- NPI 1699704155
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.