Individual provider Active NPI

Kent Kosmatka, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Marion, IL
National Provider Identifier
1891771770
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26167 Issued in SC
Practice address
3333 W Deyoung St
Marion, IL 62959-5884
Phone
(660) 826-5960
Fax
(660) 826-4852
NPI assigned
Dec 21, 2005
Last updated
Jan 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209000291 IL
Certified Registered Nurse Anesthetist 367500000X 26167 SC Primary

Addresses

Primary practice location

3333 W Deyoung St
Marion, IL 62959-5884

Mailing address

PO Box 503256
Saint Louis, MO 63150-0001
Phone (660) 826-5960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171005003208 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012902992 Reassigns benefits to 2 organizations
I20230505001475 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012902992 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians
Low Country Anesthesia, PAGroup PAC ID 8729063797, 62 clinicians

Practice addresses (Care Compare)

1000 Medical Ctr Dr
Hardeeville, SC 29927-3446
Phone (843) 784-8000

955 Ribaut Rd
Beaufort, SC 29902-5441
Phone (800) 228-0249

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26167SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Anesthesia PC CurrentSince Jan 14, 2025 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 21, 2023 Accepting new patients
East Morgan County Hospital CurrentSince Nov 1, 2017 Accepting new patients
Cep America - Anesthesia PC CurrentSince Jan 14, 2025 Accepting new patients
East Morgan County Hospital CurrentSince Nov 1, 2017 Accepting new patients
Low Country Anesthesia, PA CurrentSince Aug 1, 2023 Accepting new patients
Great Plains of Cheyenne Co. Inc Past Accepting new patients
Marion Surgery Center LTD Past Accepting new patients
Marion Hospital Corporation Nurse Anesthetist, Certified Registered Past Accepting new patients
Sterling Regional Medcenter Past Accepting new patients
Marion Surgery Center LTD Nurse Anesthetist, Certified Registered Past Accepting new patients
Great Plains of Cheyenne Co. Inc Past Accepting new patients
Goodland Regional Medical Center Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

2400 Edison St
Brush, CO 80723
Phone (970) 842-2833

909 E Railroad Ave
Fort Morgan, CO 80701
Phone (970) 542-4700

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

1000 Medical Center Dr
Hardeeville, SC 29927
Phone (843) 784-8138

25 Hospital Ctr
Hilton Head Island, SC 29926
Phone (843) 682-2345

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

Organizations & group practices 13

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.

View all 13

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": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1891771770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 503256",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631500001",
            "telephone_number": "660-826-5960",
            "fax_number": "660-826-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 W DEYOUNG ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595884",
            "telephone_number": "660-826-5960",
            "fax_number": "660-826-4852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSMATKA",
        "first_name": "KENT",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209000291",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "26167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; 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.