Individual provider Active NPI

Kristofer J Feeko, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
National Provider Identifier
1326350679
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
OS016535 Issued in PA
Practice address
25 S 9TH St FL 1
Philadelphia, PA 19107-4408
Phone
(215) 955-1200
Fax
(215) 923-6808
NPI assigned
Jul 1, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician 2081P0301X OS016535 PA
Physical Medicine & Rehabilitation Physician 208100000X OS016535 PA Primary

Addresses

Primary practice location

25 S 9TH St FL 1
Philadelphia, PA 19107-4408

Mailing address

25 S 9TH St FL 1
Philadelphia, PA 19107-4408
Phone (215) 955-1200

Other practice location 1

3 Crescent Dr Fl 3
Philadelphia, PA 19112-1016
Phone (215) 503-3321

Other identifiers 2

IdentifierTypeStateIssuer
0364975MedicaidNJ
102847316 0001MedicaidPA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130903000183 PA Practitioner - Physical Medicine and Rehabilitation 6800039397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Philadelphia College of Osteopathic Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

25 S 9TH St
1St Floor
Philadelphia, PA 19107-4408
Phone (215) 955-1200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS016535PAMDBrain Injury Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians Physical Medicine & Rehabilitation CurrentSince Aug 1, 2013 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

3 Crescent Dr
Fl 3
Philadelphia, PA 19112
Phone (215) 503-3321

25 S 9th St
Fl 1
Philadelphia, PA 19107
Phone (215) 955-1200

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1326350679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 S 9TH ST FL 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074408",
            "telephone_number": "215-955-1200",
            "fax_number": "215-923-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 S 9TH ST FL 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074408",
            "telephone_number": "215-955-1200",
            "fax_number": "215-923-6808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Crescent Dr Fl 3",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191121016",
            "country_code": "US",
            "telephone_number": "215-503-3321",
            "fax_number": "215-503-7180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEEKO",
        "first_name": "KRISTOFER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-01",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0301X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Brain Injury Medicine",
            "state": "PA",
            "license": "OS016535",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "OS016535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0364975",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102847316 0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.