MR. NICHOLAS MICHAEL KOSTISHAK PA-C ATC NPI 1487085676

NPI Information

  • NPI: 1487085676
  • Provider Name: MR. NICHOLAS MICHAEL KOSTISHAK, PA-C, ATC
  • Classification: Physician Assistant - 363A00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1000 10TH AVE # 2A05
    NEW YORK, NY
    ZIP 10019
  • Phone: (516) 375-6459

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NPI Details

MR. Nicholas Michael Kostishak, PA-C, ATC is a physician assistant in New York, NY. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. MR. Nicholas Michael Kostishak, PA-C, ATC NPI is 1487085676. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1000 10TH AVE # 2A05
NEW YORK, NY
ZIP 10019-147
Phone: (516) 375-6459

The NPI 1487085676 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/12/2013 and was last updated on 1/30/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12255A2300XSpecialist/TechnologistAthletic Trainer002702NEW YORKNo
2363A00000XPhysician Assistant024450NEW YORKYes
32255A2300XSpecialist/TechnologistAthletic Trainer1134ARIZONANo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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