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MR. NICHOLAS MICHAEL KOSTISHAK JR. PA-C, ATC
NPI 1487085676
Physician Assistant in New York, NY

Active since December 12, 2013PECOS EnrolledAccepts Medicare Assignment
1000 10TH AVE # 2A05, NEW YORK, NY 10019(516) 375-6459 Get Directions Write a Review

NPPES record last updated: January 30, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 30, 2023, Jan 31, 2020, Oct 25, 2019 and 1 more (4 updates tracked since 2019).

About Mr. Nicholas Michael Kostishak Jr. Pa-c, Atc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. NICHOLAS MICHAEL KOSTISHAK JR. PA-C, ATC (NPI 1487085676) is an individual physician assistant in New York, New York, licensed in New York (024450) and active in the NPI registry since December 2013. He is enrolled in Medicare PECOS, is affiliated with Mount Sinai St Luke's Roosevelt Hospital, and maintains a secondary practice location in Wantagh.

NPPES Registry Identity

NPI1487085676
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. NICHOLAS MICHAEL KOSTISHAK JR.Credential: PA-C, ATC
Location Address1000 10TH AVE # 2A05New York, NY 10019-1147
Mailing Address3469 Stephen LnWantagh, NY 11793-3105 · (516) 375-6459
Phone(516) 375-6459
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateDecember 12, 2013
Last NPPES UpdateJanuary 30, 20234 updates tracked since enumeration
NPPES CertifiedJanuary 30, 2023
✔ NPI 1487085676 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NY · 024450
Definition
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.
Also ListedSpecialist/Technologist · Athletic TrainerTaxonomy 2255A2300X · License 002702 (NY), 1134 (AZ)
1000 10TH AVE # 2A05, New York, NY 10019
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Secondary Practice Location 1

Location 13469 Stephen LnWantagh, NY 11793-3105 · Phone (516) 375-6459

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Nicholas Michael Kostishak Jr. Pa-c, Atc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991192890
PECOS Enrollment IDI20220628000084
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mount Sinai St Luke's Roosevelt Hospital

Acute Care Hospitals · New York, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330046
Location1000 Tenth AvenueNew York, NY 10019 · New York County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10019 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicholas Kostishak's NPI number?

The NPI number for Nicholas Kostishak is 1487085676. It was assigned to this individual provider in the NPPES registry on December 12, 2013.

Where is Nicholas Kostishak located?

Nicholas Kostishak practices at 1000 10th Ave # 2a05, New York, NY 10019. The listed phone number is (516) 375-6459.

What is Nicholas Kostishak's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Nicholas Kostishak enrolled in Medicare?

Yes. Nicholas Kostishak is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Nicholas Kostishak affiliated with any hospitals?

According to CMS data, Nicholas Kostishak is affiliated with Mount Sinai St Luke's Roosevelt Hospital.

When was this NPI record last updated?

The NPPES record for Nicholas Kostishak was last updated on January 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.