Jordana Koller, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

088973 Issued in NY

Practice address

750 Tilden Street
Bronx, NY 10467-6013

Phone

(718) 231-3400

NPI assigned

Dec 23, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Interborough Developmental and Consultation Center, Inc.

  dba LSA Recovery

  • Case Management Agency
  • Brooklyn, NY
  • NPI 1588611842
  Medicare reassignment

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

{
    "created_epoch": "1387756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388016000000",
    "number": "1851712566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 WALCOTT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146311",
            "telephone_number": "718-231-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 TILDEN STREET",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104676013",
            "telephone_number": "718-231-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLER",
        "first_name": "JORDANA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-23",
        "last_updated": "2013-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "088973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASWB",
            "identifier": "088973",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Svetlana Kolesnik, PMHNP
• Erika Kolisch, DNP, APRN, FNP-BC
• Pramila Kumari Kolisetty, MD
• Caroline Kollars
• Mercy J Kollek
• Srinivasa R Kolli, PHARMACIST
• John C Kolodziej, MS CCC SLP
• Alissa Koloff
• Victor Koltenyuk, MD
• Sky Koltun

• Social Worker in Bronx, NY
• Providers in Bronx, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.