Jensen Grey Kolaczko, M.D.

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

DR.0068168 Issued in CO

Practice address

2500 Metrohealth Dr
Cleveland, OH 44109-1900

Phone

(216) 778-7800

NPI assigned

Apr 18, 2017

Last updated

Nov 6, 2023By 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 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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.

Enrollment records 1

Specialty

Orthopedic Surgery

Education

Wright State University Boonshoft School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Metrohealth SystemGroup PAC ID 8628982949, 1,150 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Metrohealth System Hospital, Cleveland, OH, CCN 360059

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• The Metrohealth System

  dba Metrohealth Professional Group

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1053353896
  Medicare reassignment Care Compare group NPD
• The Metrohealth System

  dba Metrohealth Medical Center

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1700828852
  NPD
• The Metrohealth System

  dba MetroHealth Brooklyn Memphis Pharmacy

  • Pharmacy
  • Cleveland, OH
  • NPI 1992529911
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Metrohealth System

  dba Metrohealth Life Flight

  • Air Ambulance
  • Cleveland, OH
  • NPI 1609043645

  Hospital

  Care Compare affiliation
• The Metrohealth System

  dba Metrohealth Medical Center

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1700828852
  Care Compare affiliation

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1083148852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-778-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLACZKO",
        "first_name": "JENSEN",
        "middle_name": "GREY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-18",
        "last_updated": "2023-11-06",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CO",
            "license": "DR.0068168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkolaczko254421@direct.metrohealth.org",
            "affiliation": "N",
            "address_1": "2500 Metrohealth Dr",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441091900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shweta Koirala, M.D
• Ali Murat Kokat
• Tod Kokensparger, P.T.
• Lynne Kokoczka, APRN-CNS
• Rei Kola, DO
• Nancy G Kolaczko, RN
• Krystyna Marie Kolaczynski, M.D.
• Emily Marie Kolb, SWT
• Michael C Kolczun, MD
• Rawan Koleilat

• Sports Medicine (Orthopaedic Surgery) Physician in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.