Individual provider Active NPI

Adam Kokoszka, CRNA

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
National Provider Identifier
1821180076
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
073537 Issued in NC
Practice address
200 Hawthorne LN
Charlotte, NC 28204-2515
Phone
(704) 384-4239
Fax
(704) 384-5636
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 073537 NC Primary

Addresses

Primary practice location

200 Hawthorne LN
Charlotte, NC 28204-2515

Mailing address

PO Box 601549
Charlotte, NC 28260-1549
Phone (704) 384-4239

Other identifiers 2

IdentifierTypeStateIssuer
8052230MedicaidNC
2608907BOtherNCMEDICARE ID

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address AKOKOSZKA79431@DIRECT.NOVANTHEALTH.ORG

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050427000772 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193764397 Reassigns benefits to 17 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
The Presbyterian HospitalGroup PAC ID 1153231907, shared by 10 NPIs, 412 clinicians
Novant Health Matthews Medical Center LLCGroup PAC ID 6406845247, 76 clinicians

Practice addresses (Care Compare)

10030 Gilead Rd
Huntersville, NC 28078-7545
Phone (336) 277-8757

1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-6500

Hospital & facility affiliations

  • Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
073537NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Anesthesia Services Group Inc CurrentSince Nov 28, 2017 Accepting new patients
Medical Park Hospital LLC CurrentSince May 17, 2020 Accepting new patients
Novant Health Rowan Medical Center, LLC CurrentSince Mar 16, 2017 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince May 17, 2020 Accepting new patients
Brunswick Community Hospital, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2016 Accepting new patients
Novant Health Kernersville Outpatient Surgery LLC Nurse Anesthetist, Certified Registered CurrentSince May 17, 2020 Accepting new patients
The Presbyterian Hospital Current Accepting new patients
Presbyterian Sameday Surgery Center at Huntersville LLC Current Accepting new patients
The Presbyterian Hospital Nurse Anesthetist, Certified Registered CurrentSince Feb 26, 2007 Accepting new patients
Novant Health Kernersville Outpatient Surgery LLC Current Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Novant Health Thomasville Medical Center, LLC Nurse Anesthetist, Certified Registered CurrentSince May 17, 2020 Accepting new patients
The Presbyterian Hospital CurrentSince Feb 26, 2007 Accepting new patients
Novant Health Clemmons Outpatient Surgery, LLC Nurse Anesthetist, Certified Registered CurrentSince May 17, 2020 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Dec 1, 2013 Accepting new patients
Presbyterian Sameday Surgery Center at Ballantyne LLC Current Accepting new patients
NMG Southpark Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2012 Accepting new patients
Novant Health Rowan Medical Center LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 16, 2017 Accepting new patients
Novant Health Mint Hill Medical Center, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2018 Accepting new patients
Forsyth Memorial Hospital, Inc. Nurse Anesthetist, Certified Registered CurrentSince May 17, 2020 Accepting new patients
Presbyterian Sameday Surgery Center at Huntersville LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2017 Accepting new patients
Medical Park Hospital LLC CurrentSince May 17, 2020 Accepting new patients
Novant Health Thomasville Medical Center LLC CurrentSince May 17, 2020 Accepting new patients
Novant Health Clemmons Outpatient Surgery, LLC Current Accepting new patients
Novant Health Ballantyne Medical Center LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2023 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2013 Accepting new patients
The Presbyterian Hospital CurrentSince Mar 1, 2016 Accepting new patients
Novant Health Matthews Medical Center LLC CurrentSince Nov 5, 2016 Accepting new patients
Presbyterian Sameday Surgery Center at Ballantyne LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2017 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Past Accepting new patients
Regional Anesthesia, PLLC Past Accepting new patients
Durham Anesthesia Associates PA Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

240 Hospital Dr NE
Bolivia, NC 28422
Phone (336) 399-7678

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

200 Hawthorne Ln
Fl 2
Charlotte, NC 28204
Phone (704) 384-4274

14215 Ballantyne Corporate Pl
Ste 210
Charlotte, NC 28277
Phone (704) 316-2650

8201 Healthcare Loop
Charlotte, NC 28215
Phone (980) 302-1000

6035 Fairview Rd
Charlotte, NC 28210
Phone (336) 718-2078

10905 Providence Rd W
Charlotte, NC 28277
Phone (980) 488-4000

7210 Village Medical Cir
Ste 235
Clemmons, NC 27012
Phone (336) 893-3100

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

10030 Gilead Rd
Huntersville, NC 28078
Phone (704) 316-4000

1730 Kernersville Medical Pkwy
Ste 304
Kernersville, NC 27284
Phone (336) 515-7000

710 Park Center Dr
Ste 100
Matthews, NC 28105
Phone (336) 718-2078

1500 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 384-6500

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

1950 S Hawthorne Rd
Winston Salem, NC 27103
Phone (336) 718-0600

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Interoperability endpoints

  • Direct secure messaging: akokoszka79431@direct.novanthealth.org

Organizations & group practices 33

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.

View all 33

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1821180076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601549",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601549",
            "telephone_number": "704-384-4239",
            "fax_number": "704-384-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042515",
            "telephone_number": "704-384-4239",
            "fax_number": "704-384-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOKOSZKA",
        "first_name": "ADAM",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "073537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8052230",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "2608907B",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "AKOKOSZKA79431@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "200 Hawthorne Ln",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.