Individual provider Active NPI

Maria Kossilos, RPH

  • Pharmacist
  • Cambridge, MA
National Provider Identifier
1982988705
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
25312 Issued in MA
Practice address
1493 Cambridge St
Outpatient Pharmacy, 2ND Floor
Cambridge, MA 02139-1047
Phone
(617) 665-1438
Fax
(617) 665-1148
NPI assigned
Sep 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 25312 MA Primary

Addresses

Primary practice location

1493 Cambridge St
Outpatient Pharmacy, 2ND Floor
Cambridge, MA 02139-1047

Mailing address

1035 Cambridge St Ste 2
Cambridge, MA 02141-1154
Phone (617) 806-8505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
25312MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission Past Accepting new patients

Organizations & group practices 1

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": "1317254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1982988705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 CAMBRIDGE ST STE 2",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021411154",
            "telephone_number": "617-806-8505",
            "fax_number": "617-806-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1493 CAMBRIDGE ST",
            "address_2": "OUTPATIENT PHARMACY, 2ND FLOOR",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391047",
            "telephone_number": "617-665-1438",
            "fax_number": "617-665-1148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSSILOS",
        "first_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-29",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "25312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.