Jessica Ann Koscelnak, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

334804 Issued in NY

Practice address

40 Mitchell Avenue
Binghamton, NY 13903

Phone

(607) 772-0639

Fax

(607) 722-4610

NPI assigned

Mar 1, 2006

Last updated

Jan 5, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jessica Ann Dibble Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkoscelnak196745@direct-guthrie.org

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.

• Exigence Medical of Binghamton PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Binghamton, NY
  • NPI 1659464758
  Medicare reassignment NPD
• Southern Tier Medical Care - Ny PC

  • Internal Medicine Physician
  • Binghamton, NY
  • NPI 1134646276
  NPD

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231113600000",
    "number": "1053388801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 GRAND AVE",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902558",
            "telephone_number": "607-763-6293",
            "fax_number": "607-763-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 MITCHELL AVENUE",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "13903",
            "telephone_number": "607-772-0639",
            "fax_number": "607-722-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSCELNAK",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2009-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "334804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02728150",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "DIBBLE",
            "middle_name": "ANN",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kate Marie Kocan
• Jennifer Lynn Kolesar, PHARM.D.
• Lydia Komatinsky, RN
• Bharath Kondapavuluri, MD
• Alexandra Marie Kopalek, OTR/L
• Kristine Koster
• Julie Kotasek
• Linda L Kotasek, BS
• Andin Kovarik Roeber, FNP
• Aida Socie Kradjian, MSW

• Family Nurse Practitioner in Binghamton, NY
• Providers in Binghamton, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.