Nathan W Koller, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA064644 Issued in PA

Practice address

500 Upper Chesapeake Dr
Bel Air, MD 21014-4324

Phone

(443) 643-1500

Fax

(443) 643-1505

NPI assigned

Aug 11, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MD, PA2 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 2

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinnacle Health Hospitalist Services LLCGroup PAC ID 9739313545, 180 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Upmc Hanover Hospital, Hanover, PA, CCN 390233

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: nkoller293260@upmc.direct-ci.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.

• Pinnacle Health Hospitalist Services LLC

  • Hospitalist Physician
  • Harrisburg, PA
  • NPI 1023458148
  Medicare reassignment Care Compare group
• Adfinitas Health at Upper Chesapeake Harford Memorial LLC

  • Hospitalist Physician
  • Havre de Grace, MD
  • NPI 1457051724
  Medicare reassignment
• Upper Chesapeake Critical Care Associates, LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Bel Air, MD
  • NPI 1538367545
  Medicare reassignment
• Upper Chesapeake Medical Services, Inc

  • Hospitalist Physician
  • Bel Air, MD
  • NPI 1497801419
  Medicare reassignment

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

• Upmc Hanover

  • Clinic/Center
  • Hanover, PA
  • NPI 1700084944

  Hospital

  Care Compare affiliation
• Upmc Hanover

  • General Acute Care Hospital
  • Hanover, PA
  • NPI 1730158981
  Care Compare affiliation

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1497060727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UPPER CHESAPEAKE DR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144324",
            "telephone_number": "443-643-1500",
            "fax_number": "443-643-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UPPER CHESAPEAKE DR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144324",
            "telephone_number": "443-643-1500",
            "fax_number": "443-643-1505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6701 N Charles St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212046808",
            "country_code": "US",
            "telephone_number": "443-849-8046",
            "fax_number": "443-849-8057",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Hanover",
            "state": "PA",
            "postal_code": "173312297",
            "country_code": "US",
            "telephone_number": "717-316-3711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLLER",
        "first_name": "NATHAN",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-11",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0004217",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA064644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nkoller254045@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "300 Highland Ave",
            "city": "Hanover",
            "state": "PA",
            "country_code": "US",
            "postal_code": "173312297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karen L Koermer, PT
• Tara M Koester, DPT
• Carole Benisch Kohl, CRNP MS RN
• James Fredrick Kohl, MSSW LCSW C
• Heather Arlene Kohlbus, ATC
• Caroline V. Koluch, R.PH, MBA
• Keleigh Dawn Kongkraphun, LCPC
• Teri Joyce Kopczynski, ED.S. CCC-SLP
• Tara Kopp
• Wendi Korn, MS CCC-SLP

• Physician Assistant in Bel Air, MD
• Providers in Bel Air, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.