Individual provider Active NPI

Corinne Kokolis, RPAC

  • Medical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1114019635
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0050571 Issued in NY
Practice address
648 Bay Ridge Parkway
Brooklyn, NY 11209
Phone
(718) 748-8282
Fax
(718) 836-8113
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0050571 NY Primary

Addresses

Primary practice location

648 Bay Ridge Parkway
Brooklyn, NY 11209

Mailing address

648 Bay Ridge Parkway
Brooklyn, NY 11209
Phone (718) 748-8282

Other identifiers 1

IdentifierTypeStateIssuer
01708438MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100610000199 NY Practitioner - Physician Assistant 9638209158 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maimonides Faculty Practice PlanGroup PAC ID 7012808348, 251 clinicians

Practice addresses (Care Compare)

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-6000

Hospital & facility affiliations

  • VNS of Ny Home Care Chha Home health agency, New York, NY, CCN 337008
  • Prime Home Health Services, LLC Home health agency, Brooklyn, NY, CCN 337190
  • Maimonides Medical Center Hospital, Brooklyn, NY, CCN 330194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0050571NYMDMedical Physician Assistant

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114019635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 BAY RIDGE PARKWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11209",
            "telephone_number": "718-748-8282",
            "fax_number": "718-836-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 BAY RIDGE PARKWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11209",
            "telephone_number": "718-748-8282",
            "fax_number": "718-836-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOKOLIS",
        "first_name": "CORINNE",
        "credential": "RPAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "0050571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01708438",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.