Individual provider Active NPI

Andreas Cosmatos, MD

  • Internal Medicine Physician
  • Astoria, NY
National Provider Identifier
1881664456
Registry record updated Dec 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
157197 Issued in NY
Practice address
2747 Crescent St
Suite 201
Astoria, NY 11102-3142
Phone
(718) 726-0133
Fax
(718) 726-7385
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 157197 NY Primary

Addresses

Primary practice location

2747 Crescent St
Suite 201
Astoria, NY 11102-3142

Mailing address

2747 Crescent St
Suite 201
Astoria, NY 11102-3142
Phone (718) 726-0133

Other identifiers 1

IdentifierTypeStateIssuer
00888091MedicaidNY

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
I20040302000509 NY Practitioner - Internal Medicine 8325935646 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259712000000",
    "number": "1881664456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2747 CRESCENT ST",
            "address_2": "SUITE 201",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111023142",
            "telephone_number": "718-726-0133",
            "fax_number": "718-726-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2747 CRESCENT ST",
            "address_2": "SUITE 201",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111023142",
            "telephone_number": "718-726-0133",
            "fax_number": "718-726-7385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSMATOS",
        "first_name": "ANDREAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2009-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "157197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00888091",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

Verify at the official NPI Registry.