NPIMap

Individual provider Active NPI

William J Kozak Jr., MD

  • Family Medicine Physician
  • Connellsville, PA
National Provider Identifier
1912908914
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD422207 Issued in PA
Practice address
2620 Memorial Blvd
Connellsville, PA 15425-1488
Phone
(724) 626-0700
Fax
(724) 626-8700
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD422207 PA Primary

Addresses

Primary practice location

2620 Memorial Blvd
Connellsville, PA 15425-1488

Mailing address

506 Athena Dr
Delmont, PA 15626-1005
Phone (724) 468-6869

Other identifiers 1

IdentifierTypeStateIssuer
0019646830002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060328000742 PA Practitioner - Family Practice 7012925316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

2620 Memorial Blvd
Suite C
Connellsville, PA 15425-1488
Phone (724) 626-0700

Hospital & facility affiliations

  • Amedisys Home Health of PA Home health agency, Uniontown, PA, CCN 397139
  • Amedisys Hospice of PA Hospice, Uniontown, PA, CCN 391544
  • Penn Highlands Connellsville Hospital, Connellsville, PA, CCN 390184
  • Excela Health - Frick Hospital Hospital, Mount Pleasant, PA, CCN 390217
  • Uniontown Hospital Hospital, Uniontown, PA, CCN 390041
  • Excela Health Westmoreland Regional Hospital Hospital, Greensburg, PA, CCN 390145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD422207PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Highlands Hospital and Health Center Family Medicine CurrentSince Apr 11, 2022 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

814 Vanderbilt Rd
Connellsville, PA 15425
Phone (724) 628-0450

2618 Memorial Blvd
Ste B
Connellsville, PA 15425
Phone (724) 626-0700

401 E Murphy Ave
Connellsville, PA 15425
Phone (724) 626-2343

1163 Country Club Rd
Monongahela, PA 15063
Phone (724) 258-1000

Interoperability endpoints

  • Direct secure messaging: william.kozak.2@14821.direct.athenahealth.com

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 21

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1912908914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 ATHENA DR",
            "city": "DELMONT",
            "state": "PA",
            "postal_code": "156261005",
            "telephone_number": "724-468-6869",
            "fax_number": "724-468-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 MEMORIAL BLVD",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154251488",
            "telephone_number": "724-626-0700",
            "fax_number": "724-626-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZAK",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD422207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019646830002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Connellsville, PA

Sources for this page

Verify at the official NPI Registry.