Individual provider Active NPI

Jacqueline Cosme

  • Pediatric Adolescent Medicine Physician
  • New York, NY
National Provider Identifier
1811096506
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
185090 Issued in NY
Practice address
390 W End Ave
New York, NY 10024-6107
Phone
(212) 787-1444
Fax
(212) 799-8620
NPI assigned
Sep 21, 2006
Sex
Female
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
Pediatric Adolescent Medicine Physician 2080A0000X 185090 NY Primary

Addresses

Primary practice location

390 W End Ave
New York, NY 10024-6107

Mailing address

220 Riverside Blvd
Apt. 18D
New York, NY 10069-1001
Phone (212) 860-0582

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
I20171206002656 NY Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 1355608902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
185090NYMDPediatric Adolescent Medicine Physician

Networks

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

Interoperability endpoints

  • Direct secure messaging: jcosme674275@nychhc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811096506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 RIVERSIDE BLVD",
            "address_2": "APT. 18D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100691001",
            "telephone_number": "212-860-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 W END AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246107",
            "telephone_number": "212-787-1444",
            "fax_number": "212-799-8620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSME",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "185090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.