Active NPI
Lauren Ashli Kjos, PA-C
- Physician Assistant
- Philadelphia, PA
National Provider Identifier
1568865749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA057256
- Practice address
- 1412-22 Fairmount Avenue
Delaware Valley Community Health
Philadelphia, PA 19130 - Phone
- (215) 684-5344
- NPI assigned
- Oct 2, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA057256 | PA | Primary |
Addresses
Primary practice location
1412-22 Fairmount Avenue
Delaware Valley Community Health
Philadelphia, PA 19130
Mailing address
15044 Wilson Hill Road
Georgetown, DE 19947
Phone (302) 841-8917
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Philadelphia College of Osteopathic Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1151 N Adair St
Cornelius, OR 97113-8900
Phone (503) 359-5564
2725 SW Cedar Hills Blvd
Beaverton, OR 97005-1435
Phone (503) 352-6000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA057256 | PA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delaware Valley Community Health, Inc. | Current | Accepting new patients | |
| Delaware Valley Community Health, Inc. | Current | Accepting new patients | |
| Virginia Garcia Memorial Health Center | Past | Accepting new patients |
Locations
1412 Fairmount Ave
Philadelphia, PA 19130
Phone (215) 235-9600
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 and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Cornelius, OR
- NPI 1679528012
-
- Federally Qualified Health Center (FQHC)
- Philadelphia, PA
- NPI 1386864502
-
- Federally Qualified Health Center (FQHC)
- Philadelphia, PA
- NPI 1235956921
-
- Federally Qualified Health Center (FQHC)
- Philadelphia, PA
- NPI 1326711722
Hospital & facility affiliations 12
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital
- Hillsboro, OR
- NPI 1073817714
-
- General Acute Care Hospital
- Hillsboro, OR
- NPI 1275591984
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412208000000",
"number": "1568865749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15044 WILSON HILL ROAD",
"city": "GEORGETOWN",
"state": "DE",
"postal_code": "19947",
"telephone_number": "302-841-8917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1412-22 FAIRMOUNT AVENUE",
"address_2": "DELAWARE VALLEY COMMUNITY HEALTH",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19130",
"telephone_number": "215-684-5344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KJOS",
"first_name": "LAUREN",
"middle_name": "ASHLI",
"name_prefix": "Miss",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-02",
"last_updated": "2014-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA057256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; 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.