Active NPI
Kristopher Paul Korsakoff, M.D.
- Gastroenterology Physician
- Vernon, NJ
National Provider Identifier
1174589246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- MA72514
- Practice address
- 212 State Route 94
Suite 1a
Vernon, NJ 07462 - Phone
- (973) 864-6029
- Fax
- (973) 864-1010
- NPI assigned
- Apr 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 235632 | NY | |
| Gastroenterology Physician | 207RG0100X | MA72514 | NJ | Primary |
| Gastroenterology Physician | 207RG0100X | MD425976 | PA |
Addresses
Primary practice location
212 State Route 94
Suite 1a
Vernon, NJ 07462
Mailing address
20 Grand Street
3Rd FL
Warwick, NY 10990-1035
Phone (845) 987-3901
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050512000600 | NY | Practitioner - Gastroenterology | 8022059732 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Rutgers New Jersey Medical School, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
15 Maple Ave
Warwick, NY 10990-1028
Phone (845) 986-2276
Hospital & facility affiliations
- Bon Secours Community Hospital
- St Anthony Community Hospital
- Morristown Medical Center
- Wayne Memorial Hospital
- Garnet Health Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.73 of 100
- Quality
- 87.82
- Promoting interoperability
- 92
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 271 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 135 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA72514 | NJ | MD | Gastroenterology Physician |
| MD425976 | PA | MD | Gastroenterology Physician |
Practice roles (1 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Twin Rivers Gastroenterology, LLP | Gastroenterology | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
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.
-
- Internal Medicine Physician
- Warwick, NY
- NPI 1487694345
NY
-
- Gastroenterology Physician
- Port Jervis, NY
- NPI 1497872162
Gastroenterology
Hospital & facility affiliations 5
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": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470096000000",
"number": "1174589246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 GRAND STREET",
"address_2": "3RD FL",
"city": "WARWICK",
"state": "NY",
"postal_code": "109901035",
"telephone_number": "845-987-3901",
"fax_number": "845-987-5979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 STATE ROUTE 94",
"address_2": "SUITE 1A",
"city": "VERNON",
"state": "NJ",
"postal_code": "07462",
"telephone_number": "973-864-6029",
"fax_number": "973-864-1010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORSAKOFF",
"first_name": "KRISTOPHER",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-26",
"last_updated": "2016-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NY",
"license": "235632",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NJ",
"license": "MA72514",
"primary": true
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "PA",
"license": "MD425976",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vernon, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; 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.