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SAMUEL RAY KOSYDAR MD
NPI 1619614369
Internal Medicine in Rochester, MN

Active since May 15, 2022PECOS EnrolledAccepts Medicare Assignment
200 1ST ST SW, ROCHESTER, MN 55905(507) 284-2511 Get Directions Write a Review

NPPES record last updated: July 17, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 17, 2023, May 15, 2022 (2 updates tracked since 2022).

About Samuel Ray Kosydar Md NPPES

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

SAMUEL RAY KOSYDAR MD (NPI 1619614369) is an individual internal medicine provider in Rochester, Minnesota, licensed in Minnesota (74771) and active in the NPI registry since May 2022. He is enrolled in Medicare PECOS and is a graduate of University Of Washington School Of Medicine (2022).

NPPES Registry Identity

NPI1619614369
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameSAMUEL RAY KOSYDARCredential: MD
Location Address200 1ST ST SWRochester, MN 55905-0001
Mailing Address200 1st St SwRochester, MN 55905-0001 · (507) 284-2511
Phone(507) 284-2511
Sole ProprietorNo
Medical School CMSUniversity Of Washington School Of MedicineGraduated 2022
Enumeration DateMay 15, 2022
Last NPPES UpdateJuly 17, 20232 updates tracked since enumeration
NPPES CertifiedJuly 17, 2023
✔ NPI 1619614369 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in MN · 74771✔ Licensed in MN · 32615
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
200 1ST ST SW, Rochester, MN 55905
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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

Samuel Ray Kosydar Md 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 ID840671541
PECOS Enrollment IDI20230810001478
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55905 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
$127.61 typical visit price
range $56.00 – $168.28
Typical copayment $31.90 (range $14.00 – $42.07)
Most-billed visit code 99204
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY LEASURE MD
Internal Medicine
200 1ST ST SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511
NATHANAEL BAILEY
Pathology (Clinical Pathology/Laboratory Medicine)
200 1ST ST SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511
NICOLE S NIPPER NP
Nurse Practitioner
200 1ST ST SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511
BRANDI D'SOUZA NP
Nurse Practitioner
200 1ST ST SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511
DR. JODI M. MOORE-WEISS OD
Optometrist
200 1ST ST SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511
JENNIFER L KERKVLIET MA
Psychologist
200 1ST ST SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511
EMMANUEL J LUJERO CRNA
Nurse Anesthetist, Certified Registered
200 1ST ST SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511
JUAN PABLO BRITO CAMPANA M.D
Internal Medicine (Endocrinology, Diabetes & Metabolism)
200 1ST ST SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511

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 Samuel Kosydar's NPI number?

The NPI number for Samuel Kosydar is 1619614369. It was assigned to this individual provider in the NPPES registry on May 15, 2022.

Where is Samuel Kosydar located?

Samuel Kosydar practices at 200 1st St SW, Rochester, MN 55905. The listed phone number is (507) 284-2511.

What is Samuel Kosydar's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Samuel Kosydar enrolled in Medicare?

Yes. Samuel Kosydar 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.

When was this NPI record last updated?

The NPPES record for Samuel Kosydar was last updated on July 17, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.