Individual provider Active NPI

Laurie J Kostka, APNP

  • Nurse Practitioner
  • Stevens Point, WI
National Provider Identifier
1992840342
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
704 Issued in WI
Practice address
824 Illinois Avenue
Stevens Point, WI 54481
Phone
(715) 342-7500
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 704 WI Primary

Addresses

Primary practice location

824 Illinois Avenue
Stevens Point, WI 54481

Mailing address

900 Illinois Avenue
Stevens Point, WI 54481

Other identifiers 1

IdentifierTypeStateIssuer
43851300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040220000040 WI Practitioner - Nurse Practitioner 7416842133 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
704WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince May 3, 2005 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince May 3, 2005 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

824 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211500800000",
    "number": "1992840342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ILLINOIS AVENUE",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "54481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 ILLINOIS AVENUE",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "54481",
            "telephone_number": "715-342-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTKA",
        "first_name": "LAURIE",
        "middle_name": "J",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43851300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevens Point, WI

Sources for this page

Verify at the official NPI Registry.