Paul Andrew Koberna, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD062353-L Issued in PA

Practice address

2134 Sandy Dr Ste 16
State College, PA 16803-2292

Phone

(814) 272-5805

Fax

(814) 272-0110

NPI assigned

Oct 3, 2005

Sex

Male

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nittany Valley Medical Associates P.C.

  • Specialist
  • State College, PA
  • NPI 1083601249

  PA

  Medicare reassignment NPD
• Centre Geriatric Care, LLC

  • Internal Medicine Physician
  • State College, PA
  • NPI 1962166611

  Internal Medicine

  NPD
• Valley View Haven Inc.

  • Skilled Nursing Facility
  • Belleville, PA
  • NPI 1295722353
  NPD (past)

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Medi Home Health Agency, Inc.

  • Community Based Hospice Care Agency
  • State College, PA
  • NPI 1710178025

  Contracted Managing Employee

  CMS ownership

Merit-based Incentive Payment System (MIPS)

Final score

76.77 of 100Reported as group

Quality

42.77

Improvement activities

40

Cost

79.58

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pak103pcs@m1526.primeclinicalsystems.direct-ci.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 31, 2019.

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1003803263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2134 SANDY DR STE 16",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168032292",
            "telephone_number": "814-272-5805",
            "fax_number": "814-272-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2134 SANDY DR STE 16",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168032292",
            "telephone_number": "814-272-5805",
            "fax_number": "814-272-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBERNA",
        "first_name": "PAUL",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "PA",
            "license": "MD062353-L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD062353-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BC/BS",
            "identifier": "50000805",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BS",
            "identifier": "952761",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016455000003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "21920",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110237654",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PAK103PCS@M1526.primeclinicalsystems.direct-ci.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2134 Sandy Dr Ste 16",
            "city": "State College",
            "state": "PA",
            "country_code": "US",
            "postal_code": "168032292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrea Knab, M.D.
• Jodi L Kneisly, CRNP
• Knipe Hearing Aid Centers, Ince
• Sarah Knorr
• Jennifer M. Koberna, CRNP
• Suzanne Kocet, M.A., LBS, LPC
• Christopher William Kocher, MD
• Kristy Koelle, RD, LDN, CDE, CSG
• Gwyneth Kelli Koladish, M.ED
• Brian Joseph Kolar, MD

• All providers in State College, PA
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.