NPIMap

Individual provider Active NPI

Jessica Koberling, PA

  • Physician Assistant
  • Akron, OH
National Provider Identifier
1174808240
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003407RX
Practice address
3975 Embassy Pkwy
Akron, OH 44333-8320
Phone
(330) 668-4040
Fax
(330) 668-4078
NPI assigned
Oct 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.003407RX Primary

Addresses

Primary practice location

3975 Embassy Pkwy
Akron, OH 44333-8320

Mailing address

3975 Embassy Pkwy
Akron, OH 44333-8320
Phone (330) 668-4040

Other names 1

  • Jessica Dzigiel Former name

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
I20111109000704 OH Practitioner - Physician Assistant 1052584919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crystal Clinic, Inc.Group PAC ID 7214821586, 46 clinicians

Practice addresses (Care Compare)

1310 Corporate Dr
Hudson, OH 44236-4430
Phone (330) 475-1631

2007 State Route 59
Kent, OH 44240-7610
Phone (330) 673-6299

3975 Embassy Pkwy
Suite 202
Akron, OH 44333-8395
Phone (330) 668-4085

437 Portage Trail
Cuyahoga Falls, OH 44221-3227
Phone (330) 929-9136

437 Portage TRL
Cuyahoga Falls, OH 44221-3227
Phone (330) 929-9136

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as group
Quality
83.94
Promoting interoperability
100
Improvement activities
40
Cost
78.82

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Clinic Inc CurrentSince Sep 1, 2022 Accepting new patients
Crystal Clinic Orthopaedic Center, LLC Past Accepting new patients

Locations

444 N Main St
Akron, OH 44310
Phone (330) 375-6363

3975 Embassy Pkwy
Akron, OH 44333
Phone (330) 670-4242

3975 Embassy Pkwy
Ste 202
Akron, OH 44333
Phone (330) 668-4085

4466 Fulton Dr NW
Canton, OH 44718
Phone (330) 489-1386

437 Portage Trl
Cuyahoga Fls, OH 44221
Phone (330) 929-9136

3557 Embassy Pkwy
Fairlawn, OH 44333
Phone (330) 670-1005

3975 Embassy Pkwy
Ste 102
Fairlawn, OH 44333
Phone (330) 668-4050

1622 E Turkeyfoot Lake Rd
Ste 200
Green, OH 44312
Phone (330) 644-7436

1310 Corporate Dr
Hudson, OH 44236
Phone (330) 344-3030

2007 State Route 59
Kent, OH 44240
Phone (330) 673-1904

Organizations & group practices 3

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1174808240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 EMBASSY PKWY",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443338320",
            "telephone_number": "330-668-4040",
            "fax_number": "330-668-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 EMBASSY PKWY",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443338320",
            "telephone_number": "330-668-4040",
            "fax_number": "330-668-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBERLING",
        "first_name": "JESSICA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "50.003407RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "DZIGIEL",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.