Justin Koehl, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

555 Biesterfield Rd
Elk Grove Village, IL 60007-3306

Phone

(847) 690-1776

Fax

(847) 690-1777

NPI assigned

Nov 6, 2017

Last updated

Dec 7, 2021By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, WI2 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

Specialty

Physician Assistant

Education

Boston University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Core Orthopedics and Sports Medicine LLCGroup PAC ID 1850482712, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Alexius Medical Center Hospital, Hoffman Estates, IL, CCN 140290
• Alexian Brothers Medical Center 1 Hospital, Elk Grove Village, IL, CCN 140258

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: justin.koehl.1@9398.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Core Orthopedics & Sports Medicine LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Elk Grove Village, IL
  • NPI 1093918161

  WI

  Medicare reassignment Care Compare group NPD

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

• Alexian Brothers Medical Center

  • General Acute Care Hospital
  • Elk Grove Village, IL
  • NPI 1265577191
  Care Compare affiliation
• St. Alexius Medical Center

  • General Acute Care Hospital
  • Hoffman Estates, IL
  • NPI 1376644385
  Care Compare affiliation

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1952814568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 BIESTERFIELD RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073306",
            "telephone_number": "847-690-1776",
            "fax_number": "847-690-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 BIESTERFIELD RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073306",
            "telephone_number": "847-690-1776",
            "fax_number": "847-690-1777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2380 Lakewood Blvd",
            "address_purpose": "LOCATION",
            "city": "Hoffman Estates",
            "state": "IL",
            "postal_code": "601922025",
            "country_code": "US",
            "telephone_number": "847-690-1776",
            "fax_number": "847-690-1777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOEHL",
        "first_name": "JUSTIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-06",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "records@cosm.exscribedirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "XML",
            "address_1": "2380 Lakewood Blvd",
            "city": "Hoffman Estates",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601922025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Martica S King
• Kathryn S. Kirk
• Ryan Kirkpatrick, D.C.
• Michael Xavier Kittelton, LCSW
• David Klaus
• Nephtali Kogan, M.D.
• David Kolzow, MPT
• Anand Komareth, M.D.
• Predrag Konstantinovic, M.D.
• Danielle Kosanovich

• Physician Assistant in Elk Grove Village, IL
• Providers in Elk Grove Village, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.