Look up the most recent NPI and PECOS records

Kyle Michael Koster

Internal Medicine

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as KYLE KOSTER.

Based on the most recent information from CMS, provider Kyle Michael Koster is legally eligible to order and refer claims for Part B, HHA and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1366946568
Provider Type
Individual
Full Name
Koster, Kyle Michael
Title
Dr.
Credential
MD, MS

Gender
Male
Sole Proprietor
No
Enumeration Date
3/21/2018
Last Updated
10/13/2023

Contact Information

Practice Location

17 E 102nd St, New York, NY 10029-5204

(212) 659-8551

(212) 831-8116

Mailing Location

1 Gustave L Levy Pl # 1118, New York, NY 10029-6504

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 303515 New York

Kyle Michael Koster

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Horowitz, Carol R

Drapala, Michael

Shah, Divya

Domek, Maciej

John, Mala Anna

Mitta, Srilakshmi

Pashinsky, Yevgenia

Lin, Jenny J

Boal, Jeremy H

Kolod, Elizabeth