Jesse Korth, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95012974 Issued in CA

Practice address

255 N White Rd Ste 200
San Jose, CA 95127-1966

Phone

(866) 646-3553

NPI assigned

Sep 9, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NV, AZ, DC3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jesse.korth.p1@direct.caremorewest.nextgenshare.com
• Direct secure messaging: jesse.korth.1@32527.direct.athenahealth.com
• Direct secure messaging: jesse.korth.p4@direct.caremoreagp.nextgenshare.com

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.

• Carelon Medical Partners of Arizona, P.C.

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1730697483

  DC, Single Specialty

  Medicare reassignment NPD
• Carelon Medical Partners of Arizona, P.C.

  • Family Medicine Physician
  • Tucson, AZ
  • NPI 1972879773

  Single Specialty

  Medicare reassignment NPD
• Carelon Medical Partners, PC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Nashville, TN
  • NPI 1124443403

  NV, Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1504915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1457870586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28782",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951598782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N WHITE RD STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951271966",
            "telephone_number": "866-646-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORTH",
        "first_name": "JESSE",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-09",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NC",
            "license": "238714",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "WV",
            "license": "87827",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "95028029",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95012974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING NP LICENSE",
            "identifier": "95012974",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING",
            "identifier": "95029028",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Korean American Community Services
• Mark J. Korkowski, MD
• Diana Vallarta Koroi, LM, CPM
• Moses Koroma
• Alexander Korsunsky, M.D.
• Gail Ann Korza, MHRS
• Christine Suzanne Koselak
• Diane Miye Koshimune, DPM
• Shane Michael Koss
• Amy L Kostishack, MD

• Family Nurse Practitioner in San Jose, CA
• Providers in San Jose, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.