Jack Cossman, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD28358 Issued in ME

Practice address

20 York St
Yale New Haven Hospital
New Haven, CT 06510-3220

Phone

(203) 688-4242

NPI assigned

May 19, 2014

Last updated

Jul 1, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ, CA, ME4 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 4

Specialty

Dermatology

Education

Warren Alpert Medical School of Brown University, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

BB Medical and Dermatology IncGroup PAC ID 8123396447, 5 clinicians

Upper West Side Dermatology PCGroup PAC ID 7517052012, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

99.15 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• BSC 65 PLUS INDIVIDUAL MAPD
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: jcossman@upperwestside.emadirect.md
• Direct secure messaging: jcossman674278@nychhc.direct-ci.com

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.

• BB Medical and Dermatology Inc

  dba BB medical and dermatology

  • MOHS-Micrographic Surgery Physician
  • New York, NY
  • NPI 1790210516
  Medicare reassignment Care Compare group NPD
• Upper West Side Dermatology, P.C.

  • Dermatology Physician
  • New York, NY
  • NPI 1427270727
  Medicare reassignment Care Compare group
• Golden State Dermatology Associates Inc

  • Dermatology Physician
  • Walnut Creek, CA
  • NPI 1700860871
  Medicare reassignment NPD
• St. Joseph Hospital

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1154321545
  Medicare reassignment NPD
• Advanced Dermatology Associates, P.a.

  • Dermatology Physician
  • West Orange, NJ
  • NPI 1871638940
  NPD
• Golden State Dermatology Associates, Inc.

  • Ambulatory Surgical Clinic/Center
  • Fresno, CA
  • NPI 1235738576
  NPD
• California Pacific Medical Group, Inc.

  dba Brown & Toland Medical Group

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1275002453
  NPD (past)

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1912318304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3602B LONG BEACH BLVD",
            "city": "BEACH HAVEN",
            "state": "NJ",
            "postal_code": "080084139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "YALE NEW HAVEN HOSPITAL",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSSMAN",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-19",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ME",
            "license": "MD28358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Marie Cosgrove II, APRN
• Marianne Scarpati Cosgrove, CRNA
• Michelle Wong Donaghey Cosmini, CRNA
• Juliana Graciela Cossio-Baker, LCSW
• Tania A Cossio, MD
• Jose Costa, MD
• Melody Coste Sibilia
• Philip Costello Costello, APRN
• Felicity Costin
• Hannah Cote

• Dermatology Physician in New Haven, CT
• Providers in New Haven, CT by specialty
• Dermatology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.