NPIMap

Individual provider Active NPI

Kenneth J Corse II, MD

  • Diagnostic Radiology Physician
  • Plattsburgh, NY
National Provider Identifier
1962433441
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
248381 Issued in NY
Practice address
16 Degrandpre Way Ste 600
Plattsburgh, NY 12901-6454
Phone
(518) 563-0490
NPI assigned
Jul 5, 2006
Last updated
Jan 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 248381 NY Primary

Addresses

Primary practice location

16 Degrandpre Way Ste 600
Plattsburgh, NY 12901-6454

Mailing address

PO Box 2007
East Syracuse, NY 13057-4507
Phone (315) 362-5285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090401000002 NY Practitioner - Diagnostic Radiology 1456327659 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of Ny Upstate Medical University, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alice Hyde Medical CenterGroup PAC ID 4082525837, 88 clinicians
Elizabethtown Community HospitalGroup PAC ID 3577554138, shared by 3 NPIs, 62 clinicians

Practice addresses (Care Compare)

133 Park St
Malone, NY 12953-1243
Phone (518) 481-2545

75 Beekman St
Plattsburgh, NY 12901-1438
Phone (518) 561-2000

75 Park St
Elizabethtown, NY 12932-2300
Phone (518) 673-6377

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Elizabethtown Community Hospital CurrentSince May 1, 2024 Accepting new patients
Alice Hyde Medical Center Current Accepting new patients
Champlain Valley Physicians Hospital Medical Center CurrentSince May 1, 2024 Accepting new patients
Afterhours Imaging, LLC Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
Alice Hyde Medical Center CurrentSince May 1, 2024 Accepting new patients
Cmi Professional Services CurrentSince Aug 1, 2018 Accepting new patients
Elizabethtown Community Hospital Current Accepting new patients
BJC Medical Emergency Physicians, LLC Past Accepting new patients
Virginia Emergency Physicians LLP Past Accepting new patients
Hartwell Emergency Services, LLC Past Accepting new patients
Alice Hyde Medical Center Past Accepting new patients

Locations

969 State Route 11
Moira, NY 12957
Phone (518) 529-7847

16 Degrandpre Way
Ste 600
Plattsburgh, NY 12901
Phone (518) 562-7500

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

101 Adirondack Dr
Ste 1
Ticonderoga, NY 12883
Phone (518) 585-2831

107 Business Park Dr
Utica, NY 13502
Phone (315) 792-4666

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/elizabe-e663f886
  • Direct secure messaging: kcorse473207@direct.uvmhealth.org

Organizations & group practices 11

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.

Hospital & facility affiliations 6

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1962433441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2007",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130574507",
            "telephone_number": "315-362-5285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 DEGRANDPRE WAY STE 600",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129016454",
            "telephone_number": "518-563-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORSE",
        "first_name": "KENNETH",
        "middle_name": "J",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "248381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

Verify at the official NPI Registry.