David Anthony Konzem, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-07561 Issued in NC

Practice address

2880 Hulen PL
Riverside, CA 92507-2606

Phone

(951) 715-3445

NPI assigned

Dec 4, 2013

Sex

Male

Sole proprietor

Yes

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 NC

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

Merit-based Incentive Payment System (MIPS)

Final score

96.95 of 100Reported as apm

Quality

82.44

Promoting interoperability

100

Improvement activities

40

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 and National Provider Directory roles.

• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment NPD
• Emergency Coverage, LLC

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  NC

  Medicare reassignment
• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1386115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1043641822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 HULEN PL",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 HULEN PL",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072606",
            "telephone_number": "951-715-3445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1705 Tarboro St SW",
            "address_purpose": "LOCATION",
            "city": "Wilson",
            "state": "NC",
            "postal_code": "278933428",
            "country_code": "US",
            "telephone_number": "252-399-8040",
            "fax_number": "252-399-8778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONZEM",
        "first_name": "DAVID",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-04",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA51287",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorothy Naomi Kolb-Kishaba, LMFT
• John Koleth, MD
• Erwin Kong
• Fernando Kong
• Vincent Kong, DO
• Chulhwe Koo, M.D.
• Joanna Koo, DDS
• John Daniel Koontz, MD
• Juan Carlo Koontz
• Analira Koopman

• Physician Assistant in Riverside, CA
• Providers in Riverside, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; 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.