NPIMap

Individual provider Active NPI

John Joseph Kochanski IV

  • Medical Physician Assistant
  • Astoria, OR
National Provider Identifier
1578270575
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA213842 Issued in OR
Practice address
2120 Exchange St Ste 111
Astoria, OR 97103-3366
Phone
(503) 325-0333
Fax
(503) 325-6333
NPI assigned
Oct 31, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X PA213842 OR Primary

Addresses

Primary practice location

2120 Exchange St Ste 111
Astoria, OR 97103-3366

Mailing address

2120 Exchange St Ste 111
Astoria, OR 97103-3366
Phone (503) 325-0333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230306002147 OR Practitioner - Physician Assistant 8022481415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

113 S Hwy 101
Warrenton, OR 97146-9314
Phone (503) 861-6500

725 S Wahanna Rd
Seaside, OR 97138-7735
Phone (503) 717-7000

727 S Wahanna Rd
Seaside, OR 97138-7735
Phone (503) 717-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.44 of 100Reported as group
Quality
87
Promoting interoperability
100
Improvement activities
40
Cost
73.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA213842ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Aug 5, 2024 Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 5, 2024 Accepting new patients

Locations

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

Interoperability endpoints

  • Direct secure messaging: jkochanski3372228@oc.providencedirect.org

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1578270575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 EXCHANGE ST STE 111",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033366",
            "telephone_number": "503-325-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 EXCHANGE ST STE 111",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033366",
            "telephone_number": "503-325-0333",
            "fax_number": "503-325-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCHANSKI",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_suffix": "IV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-31",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA213842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, OR

Sources for this page

Verify at the official NPI Registry.