NPIMap

Individual provider Active NPI

Charles M Jesko, DC

  • Chiropractor
  • Connellsville, PA
National Provider Identifier
1619960739
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC007960L Issued in PA
Practice address
2620 Memorial Blvd Ste E
Connellsville, PA 15425-1488
Phone
(724) 322-7542
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC007960L PA Primary

Addresses

Primary practice location

2620 Memorial Blvd Ste E
Connellsville, PA 15425-1488

Mailing address

2620 Memorial Blvd Ste E
Connellsville, PA 15425-1488
Phone (724) 322-7542

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040414000354 PA Practitioner - Chiropractic 9739173469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2620 Memorial Blvd
Suite E
Connellsville, PA 15425-1488
Phone (724) 626-8890

2620 Memorial Boulevard
Suite E
Connellsville, PA 15425-1488

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chareece Chiropractic LLC Chiropractor CurrentSince Oct 1, 2023 Accepting new patients
Stuart Joseph Surkosky Chiropractor PastSince May 19, 2018 Accepting new patients

Locations

2620 Memorial Blvd
Ste E
Connellsville, PA 15425
Phone (724) 322-7542

Organizations & group practices 2

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 9

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1619960739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 MEMORIAL BLVD STE E",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154251488",
            "telephone_number": "724-322-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 MEMORIAL BLVD STE E",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154251488",
            "telephone_number": "724-322-7542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESKO",
        "first_name": "CHARLES",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007960L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Connellsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; 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.