Brian Koll, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

276952 Issued in MA

Practice address

710 Main St
Harwich Port, MA 02646-1931

Phone

(508) 905-2800

NPI assigned

Nov 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Icahn School of Medicine at Mount Sinai

  • Orthopaedic Surgery Physician
  • New York, NY
  • NPI 1124550280
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  • Infectious Disease Physician
  • New York, NY
  • NPI 1659639524

  Internal Medicine

  NPD
• Icahn School of Medicine at Mount Sinai

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• Beth Israel Medical Center

  • Internal Medicine Physician
  • New York, NY
  • NPI 1861457202
  NPD (past)
• Bimc Faculty Practice

  • Neurology Physician
  • New York, NY
  • NPI 1891848461
  NPD (past)

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1225019367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 MAIN ST",
            "city": "HARWICH PORT",
            "state": "MA",
            "postal_code": "026461931",
            "telephone_number": "508-905-2800",
            "fax_number": "774-209-3228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 MAIN ST",
            "city": "HARWICH PORT",
            "state": "MA",
            "postal_code": "026461931",
            "telephone_number": "508-905-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "First Avenue at 16th Street",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100033804",
            "country_code": "US",
            "telephone_number": "212-420-2853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLL",
        "first_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "175611",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "175611",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MA",
            "license": "276952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01475938",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah F. Johnson, FNP
• Stephanie Jordan
• Michelle Kelly, LICSW
• Adria Marie Kennedy, PMHNP-BC
• Kelly King, MD
• Anthony Kyriakides
• Marian D Lalevee, MS RD CDE LDN
• Mary Beth Lean, PSY.D.
• Si Cheng Lei
• Caroline Magnavita, LCSW

• Infectious Disease Physician in Harwich Port, MA
• Providers in Harwich Port, MA by specialty
• Infectious Disease Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; 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.