NPIMap

Individual provider Active NPI

William John Kossenjans, P.A.-C

  • Physician Assistant
  • Milford, OH
National Provider Identifier
1134715923
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.006569RX Issued in OH
Practice address
1064 State Route 28 Unit F
Milford, OH 45150-4940
Phone
(513) 981-4050
Fax
(513) 322-4859
NPI assigned
Dec 15, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC995 KY
Physician Assistant 363A00000X 50.006569RX OH Primary

Addresses

Primary practice location

1064 State Route 28 Unit F
Milford, OH 45150-4940

Mailing address

1064 State Route 28 Unit F
Milford, OH 45150-4940
Phone (513) 981-4050

Other practice location 1

8820 Bankers St
Florence, KY 41042-4212
Phone (859) 647-9101

Other practice location 2

3333 Burnet Ave
Cincinnati, OH 45229-3026
Phone (513) 636-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211209002564 OH Practitioner - Physician Assistant 5597155374 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Urgent Care LLCGroup PAC ID 6406232230, 67 clinicians

Practice addresses (Care Compare)

1064 State Route 28
Unit F
Milford, OH 45150-4940
Phone (513) 981-4050

454 Ohio Pike
Unit 38
Cincinnati, OH 45255-3394
Phone (513) 981-4201

6020 S State Route 48
Maineville, OH 45039-8280
Phone (513) 853-8800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TC995KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florence Urgent Care CurrentSince Dec 1, 2020 Accepting new patients
Children's Hospital Medical Center Physician Assistant CurrentSince Oct 14, 2021 Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

8820 Bankers St
Florence, KY 41042
Phone (859) 647-1918

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

Interoperability endpoints

  • Direct secure messaging: wkossenjans1892620@direct.bsmhealth.org

Organizations & group practices 4

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 3

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": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1134715923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 STATE ROUTE 28 UNIT F",
            "city": "MILFORD",
            "state": "OH",
            "postal_code": "451504940",
            "telephone_number": "513-981-4050",
            "fax_number": "513-322-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 STATE ROUTE 28 UNIT F",
            "city": "MILFORD",
            "state": "OH",
            "postal_code": "451504940",
            "telephone_number": "513-981-4050",
            "fax_number": "513-322-4859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8820 Bankers St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "KY",
            "postal_code": "410424212",
            "country_code": "US",
            "telephone_number": "859-647-9101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 Burnet Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452293026",
            "country_code": "US",
            "telephone_number": "513-636-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSSENJANS",
        "first_name": "WILLIAM",
        "middle_name": "JOHN",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-15",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC995",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006569RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, OH

Sources for this page

Verify at the official NPI Registry.