Michael Rudolph Cosenza, DPM

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

E4380 Issued in CA

Practice address

238 Hospital Dr Ste B
Ukiah, CA 95482

Phone

(707) 463-3668

Fax

(707) 463-3664

NPI assigned

Jun 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 1993

Medicare assignment

May accept Medicare assignment

Group practices

Lake County Tribal Health Consortium IncGroup PAC ID 8729975545, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Clearlake Hospital, Clearlake, CA, CCN 051317

Merit-based Incentive Payment System (MIPS)

Final score

90.74 of 100Reported as group

Quality

94

Promoting interoperability

92

Improvement activities

40

Cost

65.12

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: michael.cosenza.p1@direct.lcthc.nextgenshare.com

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.

• Lake County Tribal Health Consortium Inc.

  • Federally Qualified Health Center (FQHC)
  • Lakeport, CA
  • NPI 1881697381
  Care Compare group NPD (past)
• Pavilion Surgical Services LLC

  • Ambulatory Surgical Clinic/Center
  • Ukiah, CA
  • NPI 1790969301
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventist Health Clearlake Hospital Inc.

  • Critical Access Hospital
  • Clearlake, CA
  • NPI 1124018031
  Care Compare affiliation

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1811924574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 HOSPITAL DR STE B",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "95482",
            "telephone_number": "707-463-3668",
            "fax_number": "707-463-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 HOSPITAL DR STE B",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "95482",
            "telephone_number": "707-463-3668",
            "fax_number": "707-463-3664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSENZA",
        "first_name": "MICHAEL",
        "middle_name": "RUDOLPH",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "CA",
            "license": "E4380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Howard Andrew Coren, M.D.
• Mariena Renee Cornett-Steward
• Leandra Christine Corpuz, MEDICAL ASSISTANT
• Perla Corral Lopez
• Pablo Garza Cortina, M.D.
• Rileigh Cosman de Los Santos
• Meghan Nicole Cosman
• Saundra Costa
• Costco Wholesale Corporation
• Costco Wholesale Corporation

• Primary Podiatric Medicine Podiatrist in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Primary Podiatric Medicine Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.

Verify at the official NPI Registry.