Roman N Kosiborod, D.O.

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MB07566200 Issued in NJ

Practice address

39-40 Broadway Ste 1
Fair Lawn, NJ 07410

Phone

(201) 509-8998

Fax

(973) 246-7120

NPI assigned

May 23, 2005

Sex

Male

Sole proprietor

No

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 NJ, OH2 enrollments

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 2

Specialty

Anesthesiology

Education

Other, 1998

Medicare assignment

May accept Medicare assignment

Group practices

Hudson MD GroupGroup PAC ID 6103240478, 110 clinicians

Gastroenterology Consultants of North Jersey PCGroup PAC ID 4880750066, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Comprehensive Pain Medicine and Anesthesia Group, PC

  • Specialist
  • Saddle Brook, NJ
  • NPI 1942447792
  Medicare reassignment NPD Authorized official
• Hudson MD Group

  • Family Medicine Physician
  • Englewood Cliffs, NJ
  • NPI 1497301998
  Medicare reassignment Care Compare group NPD
• Gastroenterology Consultants of North Jersey PC

  • Specialist
  • Brooklyn, NY
  • NPI 1780846733

  NJ

  Medicare reassignment Care Compare group NPD
• All Health Services PC

  • Internal Medicine Physician
  • Newark, NJ
  • NPI 1093208266
  Medicare reassignment NPD
• Cardinal Treatment Centers Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Portsmouth, OH
  • NPI 1215589197
  Medicare reassignment NPD
• Cardinal Treatment Centers Piketon, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Chillicothe, OH
  • NPI 1194432591
  Medicare reassignment NPD
• Caremed Plus P.C.

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Plainfield, NJ
  • NPI 1720637150
  NPD (past) Authorized official
• Caremed Plus P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Plainfield, NJ
  • NPI 1801755855
  NPD (past) Authorized official
• Meadowlands Emergency Group Professional Corporation

  • Specialist
  • Secaucus, NJ
  • NPI 1699105379
  NPD (past) Authorized official
• Vein Health Institute PC

  • Pain Medicine (Anesthesiology) Physician
  • Franklin Lakes, NJ
  • NPI 1083382691
  NPD (past) Authorized official
• Cardinal Treatment Centers Inc

  • Home Health Agency
  • Portsmouth, OH
  • NPI 1225724412
  NPD
• County Wide Anesthesia Group, LLC

  • Specialist
  • Paterson, NJ
  • NPI 1568465979
  NPD (past)

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1831192079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 VANCE AVE",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074173016",
            "telephone_number": "201-982-4706",
            "fax_number": "973-246-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39-40 BROADWAY STE 1",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "07410",
            "telephone_number": "201-509-8998",
            "fax_number": "973-246-7120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "429 Crestwood Ave",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011444",
            "country_code": "US",
            "telephone_number": "201-342-5057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSIBOROD",
        "first_name": "ROMAN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MB07566200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isaac Kleinman, DDS
• Boris Kleyman, D.D.S.
• Charles Knapp, DDS
• Laura Jean Knapp, O.D.
• Meagan Alyssa Koch, M.S,OTR/L
• Ara Kouyoumdjian
• Ewa M Kowalczyk
• KP PT & Wellness LLC
• KR Rehab Incorporated
• Susan Jodie Kraus, MSRD

• Specialist in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; 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.