Jonathan William Kole, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

A169665 Issued in CA

Practice address

2417 Michigan Ave
Santa Monica, CA 90404-4009

Phone

(855) 446-4374

Fax

(415) 520-6405

NPI assigned

May 30, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Perelman School of Med at the University of Pennsylvania, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Headspace Medical Group (Ca), P.C.

  • Adult Mental Health Clinic/Center
  • San Francisco, CA
  • NPI 1912362252
  Medicare reassignment NPD
• Headspace Medical Group (Ca), P.C.

  • Adult Mental Health Clinic/Center
  • Santa Monica, CA
  • NPI 1629872221
  NPD

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1801233945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2417 MICHIGAN AVE",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904044009",
            "telephone_number": "855-446-4374",
            "fax_number": "415-520-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2417 MICHIGAN AVE",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904044009",
            "telephone_number": "855-446-4374",
            "fax_number": "415-520-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLE",
        "first_name": "JONATHAN",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-30",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2020013190",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "MD15904",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A169665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan M. Kohl, M.D.
• Gabriela Kohn
• Sepideh A Kohn, L.AC
• Noah Kojima, MD
• Laura Kokinda
• Steven Elliot Kolker, MD
• Eleanor F Kong, PHARM.D.
• Suchanee Kongsamoer, LMT
• Michael Kooby, D.C.
• Scott S Kopoian, PH.D.

• Child & Adolescent Psychiatry Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.