Jill Kossove, P.A.
Individual provider Active NPI Physician Assistant · Paramus, NJ
NPI 1124021589 · NPPES record last updated Dec 7, 2016
Key facts
- NPI
- 1124021589
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 25MP00125200 (NJ)
- Practice address
- 10 Forest Ave
Paramus, NJ 07652-5242 - Phone
- (201) 291-4040
- Fax
- (201) 291-0404
- NPI assigned
- May 31, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 15
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Mskcc Surgery Group
Practice addresses (Care Compare)
1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000
160 E 53Rd St
New York, NY 10022-5243
Phone (212) 610-0496
Hospital & facility affiliations
- Memorial Hospital for Cancer and Allied Diseases
- Hospital for Special Surgery
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.97 of 100
- Quality
- 82.74
- Improvement activities
- 40
- Cost
- 79.62
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NJ, NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041108001170 | NJ | Practitioner - Physician Assistant | 6901869239 | |
| I20211204000159 | NY | Practitioner - Physician Assistant | 6901869239 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles (2 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metabolic Care Associates P.a. | Past |
Accepting new patients | |
| Hartzband Center for Hip & Knee Replacement, LLC | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
Interoperability endpoints
- jkossove21679@mskcc.direct-ci.com
- https://fhir.meditouchehr.com/api/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00125200 | NJ | Yes |
Addresses
Primary practice location
10 Forest Ave
Paramus, NJ 07652-5242
Mailing address
147 Columbia Tpke
Ste 308
Florham Park, NJ 07932-2145
Phone (201) 845-9300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 161635466 | Other | NJ | TAX IDENTIFICATION # |
NPI Registry JSON
{
"created_epoch": "1117497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481068800000",
"number": "1124021589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 COLUMBIA TPKE",
"address_2": "STE 308",
"city": "FLORHAM PARK",
"state": "NJ",
"postal_code": "079322145",
"telephone_number": "201-845-9300",
"fax_number": "201-845-9301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 FOREST AVE",
"city": "PARAMUS",
"state": "NJ",
"postal_code": "076525242",
"telephone_number": "201-291-4040",
"fax_number": "201-291-0404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOSSOVE",
"first_name": "JILL",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-05-31",
"last_updated": "2016-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00125200",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX IDENTIFICATION #",
"identifier": "161635466",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Paramus, NJ
- David Leder Kornmehl
- Robert J. Korst
- Barbara Kosa
- Shanthie Elizabeth Koshy-Thomas
- Ron Koshy
- Mikhail Kotlov
- Shiva Kumar Kotturi
- Georgios Kotzias
- Angela Koza
- Arieta Kraja
All providers in Paramus, NJ · Physician Assistant in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.