DR. THEODORE ANTHONY KOSTIUK D.O. NPI 1952544876

NPI Information

  • NPI: 1952544876
  • Provider Name: DR. THEODORE ANTHONY KOSTIUK, D.O.
  • Classification: Orthopaedic Surgery - 207XS0117X
  • Specialization: Orthopaedic Surgery of the Spine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 370 N 120TH AVE STE 20
    HOLLAND, MI
    ZIP 49424
  • Phone: (616) 396-5855

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NPI Details

DR. Theodore Anthony Kostiuk, D.O. is an orthopaedic surgery of the spine orthopaedic surgery in Holland, MI with 17 years of experience. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. DR. Theodore Anthony Kostiuk, D.O. NPI is 1952544876. 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:

370 N 120TH AVE STE 20
HOLLAND, MI
ZIP 49424-196
Phone: (616) 396-5855
Fax: (616) 396-5720

The NPI 1952544876 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • X-ray of lower and sacral spine, minimum of 4 views (HCPCS:72110)
  • X-ray of lower and sacral spine, 2-3 views (HCPCS:72100)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • X-ray of middle spine, 2 views (HCPCS:72070)
  • X-ray of upper spine, 4-5 views (HCPCS:72050)
  • X-ray lower and sacral spine, 2-3 views bending views (HCPCS:72120)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Insertion of cage or mesh device to spine bone and disc space during spine fusion (HCPCS:22853)
  • X-ray of upper spine, 2-3 views (HCPCS:72040)
  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
  • Follow-up hospital inpatient care per day, typically 35 minutes (HCPCS:99233)
  • Closed treatment of broken spine bone with cast or brace (HCPCS:22310)
  • Spinal fusion (HCPCS:NAN02)
  • Laminectomy or laminotomy (partial removal of spine bones) (HCPCS:NAN18)

The enumeration date for this NPI number is 4/7/2009 and was last updated on 3/4/2019.

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
1207X00000XOrthopaedic Surgery02004389AINDIANANo
2207XS0117XOrthopaedic SurgeryOrthopaedic Surgery of the Spine5101021584MICHIGANYes
3390200000XStudent in an Organized Health Care Education/Training ProgramNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1201244390MEDICAIDINDIANA

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: 11/21/2025

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