Individual provider Active NPI

Jonathan Robert Kopka, CRNA

  • Certified Registered Nurse Anesthetist
  • Kingston, PA
National Provider Identifier
1518213586
Registry record updated Jul 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN549838 Issued in PA
Practice address
673 Wyoming Ave Apt C
Kingston, PA 18704-3862
Phone
(570) 709-1509
NPI assigned
Jul 27, 2012
Last updated
Jul 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN549838 PA Primary

Addresses

Primary practice location

673 Wyoming Ave Apt C
Kingston, PA 18704-3862

Mailing address

673 Wyoming Ave Apt C
Kingston, PA 18704-3862
Phone (570) 709-1509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121017000647 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527217934 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Anesthesia Associates PCGroup PAC ID 1759276827, 4 clinicians

Practice addresses (Care Compare)

6850 Lows Rd
Bloomsburg, PA 17815-8708
Phone (570) 784-6070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Fsljc, LLC. CurrentSince Sep 1, 2021 Accepting new patients
Lehigh Anesthesia Associates, P.C. CurrentSince Mar 1, 2020 Accepting new patients
Francis J. Collini, MD, Facs, P.C. CurrentSince Sep 1, 2021 Accepting new patients
Gulfstream Anesthesia Consultants PA Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2012 Accepting new patients

Locations

701 E 16th St
Berwick, PA 18603
Phone (570) 754-5000

6850 Lows Rd
Bloomsburg, PA 17815
Phone (570) 784-6243

875 Norman Dr
Lebanon, PA 17042
Phone (717) 272-2010

1845 Memorial Hwy
Shavertown, PA 18708
Phone (570) 674-6525

275 Guthrie Dr
Troy, PA 16947
Phone (570) 297-2121

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343347200000",
    "number": "1518213586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 WYOMING AVE APT C",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043862",
            "telephone_number": "570-709-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "673 WYOMING AVE APT C",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043862",
            "telephone_number": "570-709-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPKA",
        "first_name": "JONATHAN",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-27",
        "last_updated": "2012-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN549838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.