Individual provider Active NPI

Yelena Koss, M.D.

  • Psychiatry Physician
  • Burlingame, CA
National Provider Identifier
1487738696
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A53585 Issued in CA
Practice address
1838 El Camino Real Ste 100
Burlingame, CA 94010-3105
Phone
(650) 347-1182
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A53585 CA Primary

Addresses

Primary practice location

1838 El Camino Real Ste 100
Burlingame, CA 94010-3105

Mailing address

177 Bovet Rd FL 6
C/O CD Billing
San Mateo, CA 94402-3116
Phone (701) 255-9279

Other practice location 1

100 S San Mateo Dr
San Mateo, CA 94401-3805
Phone (650) 696-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100924000228 CA Practitioner - Psychiatry 0244356509 Practice locations: Burlingame, CA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

345 Lorton Ave
Suite 104
Burlingame, CA 94010-4134
Phone (650) 347-1182

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A53585CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1487738696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 BOVET RD FL 6",
            "address_2": "C/O CD BILLING",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023116",
            "telephone_number": "701-255-9279",
            "fax_number": "701-222-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1838 EL CAMINO REAL STE 100",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103105",
            "telephone_number": "650-347-1182"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 S San Mateo Dr",
            "address_purpose": "LOCATION",
            "city": "San Mateo",
            "state": "CA",
            "postal_code": "944013805",
            "country_code": "US",
            "telephone_number": "650-696-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSS",
        "first_name": "YELENA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A53585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

Verify at the official NPI Registry.