Jerry Kong, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00133300 Issued in NJ

Practice address

501 Iron Bridge Rd
Suite 1
Freehold, NJ 07728-5304

Phone

(732) 720-2565

Fax

(732) 720-2556

NPI assigned

Jan 9, 2008

Last updated

Jan 9, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Pain Care LLCGroup PAC ID 7315126018, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

• Advanced Pain Care LLC

  • Specialist
  • Maplewood, NJ
  • NPI 1639487259
  Medicare reassignment Care Compare group
• Mehling Orthopedics LLC

  • Orthopaedic Surgery Physician
  • Hackensack, NJ
  • NPI 1659424109
  Medicare reassignment
• Maplewood Wellness Center

  • Physical Therapist
  • Maplewood, NJ
  • NPI 1649880022
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199836800000",
    "number": "1023293909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 IRON BRIDGE RD",
            "address_2": "SUITE 1",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077285304",
            "telephone_number": "732-720-2565",
            "fax_number": "732-720-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 IRON BRIDGE RD",
            "address_2": "SUITE 1",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077285304",
            "telephone_number": "732-720-2565",
            "fax_number": "732-720-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONG",
        "first_name": "JERRY",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00133300",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00133300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Kohlberg, M.D.
• Jeanne Marie Koller, L.C.S.W.
• Ana Kolodko, CNM
• Vivian Akrive Kominos, M.D.
• David Y Kong, O.D.
• Dana Stacey Konig, LCSW
• Karen Korley, MSN-APN-C
• Jason A Kornblum, PHARMD
• Kosin Family Chiropractic Center, LLC
• Neil I Kosin, DC

• Physician Assistant in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.