Individual provider Active NPI

Jessica Ann Kovalchik, D.C.

  • Chiropractor
  • Milford, PA
National Provider Identifier
1205156148
Registry record updated Jul 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC010419 Issued in PA
Practice address
101 Drake Lane
Milford, PA 18337-1243
Phone
(570) 409-9500
Fax
(570) 409-9500
NPI assigned
Jun 2, 2010
Last updated
Jul 13, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC010419 PA Primary

Addresses

Primary practice location

101 Drake Lane
Milford, PA 18337-1243

Mailing address

101 Drake Lane
Milford, PA 18337-1243
Phone (570) 409-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110519000312 PA Practitioner - Chiropractic 2163608530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Chiropractic of MilfordGroup PAC ID 7113147919, 2 clinicians

Practice addresses (Care Compare)

101 Drakes Lane
Milford, PA 18337-9409

101 Drakes LN
Milford, PA 18337-9409
Phone (570) 409-9500

113 7TH St
Unit 6
Milford, PA 18337-1243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Chiropractic of Milford Chiropractor CurrentSince Aug 1, 2014 Accepting new patients
Tusk Counseling PastSince Nov 29, 2020 Accepting new patients
Collura Wellness Center P.C. Chiropractor PastSince Jun 1, 2016 Accepting new patients

Locations

101 Drakes Ln
Milford, PA 18337
Phone (570) 409-9500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499904000000",
    "number": "1205156148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DRAKE LANE",
            "city": "MILFORD",
            "state": "PA",
            "postal_code": "183371243",
            "telephone_number": "570-409-9500",
            "fax_number": "570-409-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DRAKE LANE",
            "city": "MILFORD",
            "state": "PA",
            "postal_code": "183371243",
            "telephone_number": "570-409-9500",
            "fax_number": "570-409-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVALCHIK",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-02",
        "last_updated": "2017-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC010419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.