MARK P KOSTELAK (NPI# 1578161105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578161105 |
| Entity Type | Individual |
| Full Name | MARK P KOSTELAK |
| Credential | CCP |
| Practice Address |
Southeast Louisiana Veterans Health Care System 2400 Canal Street New Orleans LA 70119 |
| Mailing Address |
29 Magnolia Trace Dr Harvey LA 70058-6112 |
| Practice Telephone | 5047845364 |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2020-10-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 242T00000X | Perfusionist | PEF.200076 | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
SOUTHEAST LOUISIANA VETERANS HEALTH CARE SYSTEM 2400 CANAL STREET |
| City | NEW ORLEANS |
| State | LA |
| Zip Code | 70119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922626365 | Shanika Valcour-leduff | Nurse Practitioner | 535 S Galvez St., New Orleans, LA 70119 | 2020-07-13 |
| 1932723335 | Just Health | Clinic/Center | 2800 Perdido St, New Orleans, LA 70119 | 2020-06-01 |
| 1205460235 | Lily Tran | Registered Nurse | 119 S Galvez Street, New Orleans, LA 70119 | 2020-02-28 |
| 1740823137 | Kaylyn Bernard | Case Manager/Care Coordinator | 2626 Canal St., New Orleans, LA 70119 | 2019-10-18 |
| 1114577954 | Alyssia Breion Smith | Case Manager/Care Coordinator | 1995 Gentilly Blvd. Ste. C-400, New Orleans, LA 70119 | 2019-09-13 |
| 1457903387 | Brian Steven Goldfarb | Dentist | 3701 Conti St, Apt #3403, New Orleans, LA 70119 | 2019-07-11 |
| 1013404011 | Made Positive, Inc. | Community/Behavioral Health | 3443 Esplanade Ave., Suite 215, New Orleans, LA 70119 | 2018-04-16 |
| 1972008654 | Griffin Caballero Brown | Student in an Organized Health Care Education/Training Program | 520 Jefferson Davis Hwy, New Orleans, LA 70119 | 2018-03-26 |
| 1902300544 | Kyle Raymond Hoppens | Student in an Organized Health Care Education/Training Program | 4502 Saint Ann Street, New Orleans, LA 70119 | 2018-03-20 |
| 1609384577 | Journe Dupree | Case Manager/Care Coordinator | 1995 Gentilly Blvd Ste C-400, New Orleans, LA 70119 | 2018-01-13 |
| Find all providers in zip 70119 | ||||
| Taxonomy Code | 242T00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Perfusionist |
| A perfusionist operates extracorporeal circulation and autotransfusion equipment during any medical situation where it is necessary to support or temporarily replace the patient’s circulatory or respiratory function. The perfusionist is knowledgeable concerning the variety of equipment available to perform extracorporeal circulation functions and is responsible, in consultation with the physician, for selecting the appropriate equipment and techniques to be used. |
| Notes: Source: Health Professions Career and Education Directory, American Medical Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013515253 | Charles Major | Perfusionist | 2400 Canal St, New Orleans, LA 70119-6535 | 2020-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780294819 | Carla Maul | Perfusionist | 9245 2nd St, River Ridge, LA 70123-2845 | 2020-08-04 |
| 1588155006 | Courtnie Clark Graves | Perfusionist | 3311 Prescott Rd Ste 202, Alexandria, LA 71301-3983 | 2018-05-21 |
| 1568809747 | Troy J Pavlovich | Perfusionist | 3311 Prescott Rd Ste 202, Alexandria, LA 71301-3983 | 2013-05-29 |
| 1932437886 | David Dawson IIi | Perfusionist | 8585 Picardy Ave, C/o Operating Room, Baton Rouge, LA 70809-3679 | 2009-12-03 |
| 1376688762 | Donna Turner | Perfusionist | 3311 Prescott Rd Ste 202, Alexandria, LA 71301-3983 | 2007-02-21 |
| 1740325141 | Clinton Paul Robertson | Perfusionist | 3311 Prescott Rd Ste 202, Alexandria, LA 71301-3983 | 2007-02-21 |
| City | NEW ORLEANS |
| Zip Code | 70119 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.