Jack Koburger, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9120347 Issued in FL

Practice address

636 Del Prado Blvd S
Cape Coral, FL 33990-2668

Phone

(239) 424-3513

NPI assigned

Jun 24, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cape Coral Emergency Physicians LLCGroup PAC ID 1557465325, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Cape Coral Emergency Physicians LLC

  • Emergency Medicine Physician
  • Cape Coral, FL
  • NPI 1376611962
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1750723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1538057153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6796 SMOKERISE DR",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320635256",
            "telephone_number": "904-312-2297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 DEL PRADO BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339902668",
            "telephone_number": "239-424-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBURGER",
        "first_name": "JACK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9120347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Marie Klein, PHARMD
• Sonya Imas Klein
• Hillary Capers Klos, MSPT
• Ryan Knake, PA-C
• Kimberly A. Knight, ARNP
• Jamie Lindon Kohl, ATC
• Hans Koop
• Ilana Rachele Koprowski
• Natalya Korneyeva, MSN, APRN, AGNP-C
• Suni C Koshy, DDS

• Physician Assistant in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.