Individual provider Active NPI

Jocelyn Lysbet Kohn, MD

  • Pediatric Otolaryngology Physician
  • Palo Alto, CA
National Provider Identifier
1972997369
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
A167736 Issued in CA
Practice address
801 Welch Rd FL 2
Palo Alto, CA 94304-1611
Phone
(650) 723-0457
NPI assigned
Mar 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 264458 MA
Pediatric Otolaryngology Physician 207YP0228X A167736 CA Primary

Addresses

Primary practice location

801 Welch Rd FL 2
Palo Alto, CA 94304-1611

Mailing address

801 Welch Rd FL 2
Palo Alto, CA 94304-1611

Other practice location 1

830 Harrison Ave
Moakley Building, Gound Floor
Boston, MA 02118-2905
Phone (617) 638-8124

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210825002783 CA Practitioner - Otolaryngology 3476861055 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A167736CAMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LPCH Medical Group Div of Lucile CurrentSince Aug 18, 2021 Accepting new patients
Stanford Health Care PastSince Jun 7, 2020 Accepting new patients
John Muir Health Past Accepting new patients

Locations

2400 Balfour Rd
Ste 230
Brentwood, CA 94513
Phone (925) 324-7404

801 Welch Rd
Fl 2
Palo Alto, CA 94304
Phone (650) 724-1745

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1972997369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 WELCH RD FL 2",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 WELCH RD FL 2",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041611",
            "telephone_number": "650-723-0457"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 Harrison Ave",
            "address_2": "Moakley Building, Gound Floor",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182905",
            "country_code": "US",
            "telephone_number": "617-638-8124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOHN",
        "first_name": "JOCELYN",
        "middle_name": "LYSBET",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "264458",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "CA",
            "license": "A167736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.