Timothy Kokanovich, MD
Individual provider Active NPI Hospice and Palliative Medicine (Internal Medicine) Physician · Fishersville, VA
NPI 1477057768 · NPPES record last updated Nov 26, 2024
Key facts
- NPI
- 1477057768
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X
- License
- 64460 (AZ)
- Practice address
- 51 Ivy Ridge LN
Fishersville, VA 22939-2339 - Phone
- (540) 245-7262
- Fax
- (540) 245-7054
- NPI assigned
- Mar 21, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Hospice/Palliative Care
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Augusta Medical Group
Practice addresses (Care Compare)
51 Ivy Ridge LN
Fishersville, VA 22939-2339
Phone (540) 332-5059
Hospital & facility affiliations
- Interim Healthcare - Charlottesville
- Welcome Homecare
- Augusta Home Care,
- Hospice of the Shenandoah
- Legacy Hospice
- Augusta Health
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.46 of 100
- Quality
- 90.92
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.47 of 100
- Quality
- 78.27
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.62
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241217000207 | VA | Practitioner - Hospice/Palliative Care | 6103228440 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 401 | CA | MD | Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Augusta Medical Group | Current |
Accepting new patients | |
| Augusta Medical Group | Hospice and Palliative Medicine | Current |
Accepting new patients |
Locations
70 Medical Center Cir
Ste 201
Fishersville, VA 22939
Phone (540) 221-7030
51 Ivy Ridge Ln
Fishersville, VA 22939
Phone (540) 245-7262
53 S Medical Park Dr
Fishersville, VA 22939
Phone (540) 332-5687
Interoperability endpoints
- timothy.kokanovich.1@14718.direct.athenahealth.com
- https://api.platform.athenahealth.com/14718/brand/4/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Hospice and Palliative Medicine (Internal Medicine) Physician | 207RH0002X | 64460 | AZ | Yes |
| Internal Medicine Physician | 207R00000X | 401 | CA |
Addresses
Primary practice location
51 Ivy Ridge LN
Fishersville, VA 22939-2339
Mailing address
PO Box 388
Fishersville, VA 22939-0388
Phone (540) 245-7262
Other practice location 1
5777 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone (480) 342-2000
Other practice location 2
400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-1000
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | timothy.kokanovich.1@14718.direct.athenahealth.com |
Other providers in Fishersville, VA
- Daphne Harrington Knicely
- Virginia H. Kockler
- Anagha D Kohli
- Ashlie Koiner
- Lindsey Kokanovich
- Kevin T Kollar
- David Dean Krieger
- Hannah Kukla
- Meera S Kumar
- Andrea Kurland
All providers in Fishersville, VA · Hospice and Palliative Medicine (Internal Medicine) Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.