Individual provider Active NPI

Junell Carol Koberlein, MD

  • Family Medicine Physician
  • New Port Richey, FL
National Provider Identifier
1982868865
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2014-01439 Issued in NC
Practice address
6804 Cecelia Drive
New Port Richey, FL 34653-4935
Phone
(855) 232-0644
Fax
(888) 546-0488
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301092909 MI
Family Medicine Physician 207Q00000X ME165510 FL
Family Medicine Physician 207Q00000X 2014-01439 NC Primary

Addresses

Primary practice location

6804 Cecelia Drive
New Port Richey, FL 34653-4935

Mailing address

6804 Cecelia Drive
New Port Richey, FL 34653-4935
Phone (855) 232-0644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140918000801 NC Practitioner - Family Practice 9234301193 Reassigns benefits to 1 organization
I20240801004478 FL Practitioner - Family Practice 9234301193 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobile Physician Services IncGroup PAC ID 4688685654, 39 clinicians

Practice addresses (Care Compare)

New Port Richey, FL 34653
Phone (727) 232-0644

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Orlando, FL, CCN 109494
  • Trilogy Home Healthcare Home health agency, Orlando, FL, CCN 683131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME165510FLMDFamily Medicine Physician
2014-01439NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moses Cone Medical Services, Inc. Family Medicine CurrentSince Jul 21, 2019 Accepting new patients
Mobile Physician Services Inc. CurrentSince Jun 24, 2024 Accepting new patients
Moses Cone Medical Services, Inc. Family Medicine CurrentSince Jul 21, 2019 Accepting new patients
Careconnectmd Florida P.a. CurrentSince Jun 24, 2024 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

6804 Cecelia Dr
New Prt Rchy, FL 34653
Phone (727) 232-0644

300 E Wendover Ave
Greensboro, NC 27401
Phone (336) 663-5205

1126 N Church St
Ste 300
Greensboro, NC 27401
Phone (336) 547-1700

3803 Robert Porcher Way
Greensboro, NC 27410
Phone (336) 286-3442

940 Golf House Ct E
Whitsett, NC 27377
Phone (336) 449-9848

Interoperability endpoints

  • Direct secure messaging: junell.koberlein.1@29651.direct.athenahealth.com

Organizations & group practices 5

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1982868865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6804 CECELIA DRIVE",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346534935",
            "telephone_number": "855-232-0644",
            "fax_number": "888-546-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6804 CECELIA DRIVE",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346534935",
            "telephone_number": "855-232-0644",
            "fax_number": "888-546-0488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBERLEIN",
        "first_name": "JUNELL",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301092909",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME165510",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2014-01439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

Verify at the official NPI Registry.