Jessica S Kovalchick, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

017256 Issued in NY

Practice address

105 Ridgehaven Dr
Vestal, NY 13850-2640

Phone

(607) 798-6176

NPI assigned

Sep 19, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jessica S Keller Former name

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkovalchick195811@direct-guthrie.org
• Direct secure messaging: jkovalchick@hiemail.healtheconnections.org

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.

• Our Lady of Lourdes Memorial Hospital Inc.

  • General Acute Care Hospital
  • Binghamton, NY
  • NPI 1629087580
  Medicare reassignment NPD (past)
• Our Lady of Lourdes Memorial Hospital, Inc.

  • Family Medicine Physician
  • Binghamton, NY
  • NPI 1063557189
  NPD
• Our Lady of Lourdes Memorial Hospital, Inc.

  • Specialty Pharmacy
  • Johnson City, NY
  • NPI 1730982596
  NPD
• Twin Tier Pathology Associates, PC

  • Clinical Pathology/Laboratory Medicine Physician
  • Binghamton, NY
  • NPI 1770577470
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1284854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1184932568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 RIDGEHAVEN DR",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502640",
            "telephone_number": "607-798-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 RIDGEHAVEN DR",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502640",
            "telephone_number": "607-798-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVALCHICK",
        "first_name": "JESSICA",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-19",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA054574",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "017256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessica.kovalchick@direct.lourdes.com",
            "affiliation": "N",
            "endpointDescription": "Lourdes Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "500 5th Ave",
            "city": "Owego",
            "state": "NY",
            "country_code": "US",
            "postal_code": "138271620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "KELLER",
            "middle_name": "S",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeanette S Kleger, CM
• Samantha Klenchik, PA
• Jocelyn Jaye Kocak, MS SLP
• Thomas L Komor, DPT
• Sreekanth Reddy Kondareddy, MD
• Colleen Kramer, PA
• Brett Krummenacker
• Amanda Krupka, MD
• Manish Kumar, M.D.
• Baris Mehmet Kural, M.D.

• Medical Physician Assistant in Vestal, NY
• Providers in Vestal, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.