Individual provider Active NPI

Kosta Kokolis, M.S., P.T.

  • Physical Therapist
  • New York, NY
National Provider Identifier
1851328330
Registry record updated Nov 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
023936-1 Issued in NY
Practice address
110 E 23Rd St
3Rd Floor
New York, NY 10010-4517
Phone
(212) 529-5700
Fax
(212) 529-3415
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 023936-1 NY Primary

Addresses

Primary practice location

110 E 23Rd St
3Rd Floor
New York, NY 10010-4517

Mailing address

4106 Bell Blvd
2ND Floor
Bayside, NY 11361-2857
Phone (718) 279-9800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040406001265 NY Practitioner - Physical Therapist in Private Practice 9638162514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

21426 41St Ave
Suite 130
Bayside, NY 11361-2166
Phone (718) 279-9800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
023936-1NYMDPhysical Therapist
023936NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Theramotion Physical Therapy PLLC CurrentSince Oct 11, 2018 Accepting new patients
Theramotion Physical Therapy PLLC CurrentSince Jan 30, 2004 Accepting new patients
New York Physical and Occupational Therapy, PLLC Physical Therapist Past Accepting new patients
New York Physical and Occupational Therapy PLLC Physical Therapist Past Accepting new patients

Locations

3016 30th Dr
Fl 2
Astoria, NY 11102
Phone (718) 777-2244

4106 Bell Blvd
#2
Bayside, NY 11361
Phone (718) 279-9800

21426 41st Ave
Ste 130
Bayside, NY 11361
Phone (718) 279-9800

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.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257465600000",
    "number": "1851328330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4106 BELL BLVD",
            "address_2": "2ND FLOOR",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612857",
            "telephone_number": "718-279-9800",
            "fax_number": "718-279-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E 23RD ST",
            "address_2": "3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104517",
            "telephone_number": "212-529-5700",
            "fax_number": "212-529-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOKOLIS",
        "first_name": "KOSTA",
        "credential": "M.S., P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2009-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "023936-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; 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.