Ian Koonge, MS

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

024042 Issued in NY

Practice address

315 S Manning Blvd
Albany, NY 12208-1707

Phone

(518) 525-1550

NPI assigned

Sep 19, 2019

Sex

Male

Sole proprietor

Yes

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 NY

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Capital Region Orthopaedic Associates, PCGroup PAC ID 3779496393, 67 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.85 of 100Reported as group

Quality

79.23

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ian.koonge.1@28317.direct.athenahealth.com
• Direct secure messaging: ikoonge788317@direct.trinity-health.org

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.

• Capital Region Orthopaedic Associates, PC

  • Orthopaedic Surgery Physician
  • Albany, NY
  • NPI 1871533216
  Medicare reassignment Care Compare group NPD
• Island Emergency Medical Services, P.C.

  • Emergency Medicine Physician
  • Far Rockaway, NY
  • NPI 1639160385
  Medicare reassignment

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1649820705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 JAY DR",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117931019",
            "telephone_number": "516-547-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081707",
            "telephone_number": "518-525-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONGE",
        "first_name": "IAN",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-19",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "024042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn J Konig, LCSW-R
• Hailey Konisky, MD
• Thomas Edward Konopka, LMSW
• Kellie Konye, OTR
• Simrin Singh Kooner, MD
• Heather S Kopff, D.O.
• John D Kopp, MD
• Paige Kopp
• Jenna Korim, LCSW
• Rebecca Korn, DO

• Physician Assistant in Albany, NY
• Providers in Albany, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.