Jill Kissolovege, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS-010470-L Issued in PA

Practice address

1141 Moosic St
Ste 3
Scranton, PA 18505-2105

Phone

(570) 800-5926

NPI assigned

Jun 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Internal Medicine

Education

Philadelphia College of Osteopathic Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cleanslate Medical Group of Pennsylvania LLCGroup PAC ID 8426334400, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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.

• Cleanslate Medical Group of Pennsylvania LLC

  • Multi-Specialty Clinic/Center
  • Wilkes Barre, PA
  • NPI 1184177263
  Medicare reassignment Care Compare group NPD
• Lake Scranton Urgent Care LLC

  • Urgent Care Clinic/Center
  • Scranton, PA
  • NPI 1194186957

  Internal Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486080000000",
    "number": "1235332263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 MOOSIC ST",
            "address_2": "STE 3",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185052105",
            "telephone_number": "570-800-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 MOOSIC ST",
            "address_2": "STE 3",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185052105",
            "telephone_number": "570-800-5926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSOLOVEGE",
        "first_name": "JILL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2017-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS-010470-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirelos Nasser Younan Kirelos, MD
• Corinna Jay Kirkpatrick, PA-C
• Michael Joseph Kirwin, PHD
• Lorraine Kishel, CRNP
• Nand Kishore, MD, MPH
• Diana Kitonyo
• Mackenzie Caroline Kizer
• Olivia A Klaas, LSW
• Klamp and Company LLC
• Douglas K Klamp, MD

• Internal Medicine Physician in Scranton, PA
• Providers in Scranton, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2017; 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.

Verify at the official NPI Registry.