Individual provider Active NPI

Jessica N Koval, PA-C

  • Physician Assistant
  • Erie, PA
National Provider Identifier
1679799522
Registry record updated Aug 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
100 Peach St Ste 300
Erie, PA 16507
Phone
(814) 459-1851
Fax
(814) 456-0541
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

100 Peach St Ste 300
Erie, PA 16507

Mailing address

100 Peach St Ste 300
Erie, PA 16507-1423
Phone (814) 459-1851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180928002432 PA Practitioner - Physician Assistant 5395096473 Reassigns benefits to 1 organization
I20210302000862 OH Practitioner - Physician Assistant 5395096473

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Education and Research Institute IncGroup PAC ID 3870405137, 297 clinicians

Practice addresses (Care Compare)

155 E State St
Albion Family Practice
Albion, PA 16401-1347
Phone (814) 756-4917

2315 Myrtle St
Suite L10
Erie, PA 16502-4611
Phone (814) 454-2401

Hospital & facility affiliations

  • Saint Vincent Hospital Hospital, Erie, PA, CCN 390009
  • Westfield Memorial Hospital, Inc Hospital, Westfield, NY, CCN 330801

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Vincent Consultants in Cardiovascular Diseases Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jkoval189454@direct.ahn.org

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 2

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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533254400000",
    "number": "1679799522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PEACH ST STE 300",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071423",
            "telephone_number": "814-459-1851",
            "fax_number": "814-456-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PEACH ST STE 300",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "16507",
            "telephone_number": "814-459-1851",
            "fax_number": "814-456-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVAL",
        "first_name": "JESSICA",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2018-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.