Jordan Louise Koontz, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

214 College Park PLZ
Johnstown, PA 15904-2833

Phone

(888) 918-5465

NPI assigned

Jun 11, 2018

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nulton Diagnostic and Treatment Center, PCGroup PAC ID 5294621363, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Nulton Diagnostic & Treatment Center, PC

  • Neurodevelopmental Disabilities Physician
  • Johnstown, PA
  • NPI 1073573010
  Medicare reassignment Care Compare group
• Nulton Diagnostic & Treatment Center, PC.

  • Community/Behavioral Health Agency
  • Johnstown, PA
  • NPI 1649515552
  NPD
• Windber Hospital, Inc.

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1255824686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 DUNKARD HOLLOW RD",
            "city": "ALUM BANK",
            "state": "PA",
            "postal_code": "155217706",
            "telephone_number": "814-979-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 COLLEGE PARK PLZ",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159042833",
            "telephone_number": "888-918-5465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONTZ",
        "first_name": "JORDAN",
        "middle_name": "LOUISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Rae Koesarie, MD
• Courtney Kohler
• Mary Jo Kohler, CRNA
• Raaghvi Kohli, MD
• Scott Michael Kondash, M.A.
• Hannah Nicole Kopach
• Travis George Kopach, PT
• Sarah J Kopnicky, PA-C
• Kopp Family Foot Care, PC
• Brian Joseph Kopp, DPM

• Physician Assistant in Johnstown, PA
• Providers in Johnstown, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.
• 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.