NPIMap

Individual provider Active NPI

Jeanmarie Atienza Koh, MD

  • Family Medicine Physician
  • Conemaugh, PA
National Provider Identifier
1992700371
Registry record updated May 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD052897L Issued in PA
Practice address
1940 William Penn Ave
Conemaugh, PA 15909-1609
Phone
(814) 322-1519
Fax
(814) 322-1454
NPI assigned
Jun 14, 2005
Last updated
May 3, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2019

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 MD052897L PA Primary

Addresses

Primary practice location

1940 William Penn Ave
Conemaugh, PA 15909-1609

Mailing address

1086 Franklin St
Johnstown, PA 15905-4305
Phone (814) 534-1555

Other identifiers 1

IdentifierTypeStateIssuer
001469440MedicaidPA

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
I20100629000325 PA Practitioner - Family Practice 5890826275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Vantage Physical Therapy and Rehabilitation IncGroup PAC ID 3072424886, 253 clinicians

Practice addresses (Care Compare)

1060 Lloyd St
Nanty Glo, PA 15943-1232
Phone (814) 247-3100

1086 Franklin St
Johnstown, PA 15905-4305

1086 Franklin St E
Johnstown, PA 15905-4305
Phone (814) 534-9104

1086 Franklin St M
Johnstown, PA 15905-4305
Phone (814) 534-9194

1111 Franklin St
Johnstown, PA 15905-4341

1940 William Penn Ave
Suite 1
Johnstown, PA 15909-1609
Phone (814) 322-1519

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

336 Bloomfield St
Johnstown, PA 15904-3271
Phone (814) 269-2224

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD052897LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Conemaugh Physician Practices LLC Family Medicine CurrentSince Sep 1, 2014 Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Sep 1, 2014 Accepting new patients
DLP Conemaugh Physician Practices LLC Family Medicine Current Accepting new patients
Conemaugh Health Initiatives Past Accepting new patients
Conemaugh Valley Memorial Hospital Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Conemaugh Valley Memorial Hospital Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
DLP Conemaugh Memorial Medical Center LLC Past Accepting new patients

Locations

236 Jamesway Rd
Ebensburg, PA 15931
Phone (814) 255-6781

1020 Franklin St
Johnstown, PA 15905
Phone (814) 533-1095

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

1086 Franklin St
Bldg G
Johnstown, PA 15905
Phone (914) 534-9000

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

1940 William Penn Ave
Ste 1
Johnstown, PA 15909
Phone (814) 322-1519

1060 Lloyd St
Nanty Glo, PA 15943
Phone (814) 536-6671

Interoperability endpoints

  • Direct secure messaging: jkoh7140@direct.conemaugh.org

Organizations & group practices 10

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.

Hospital & facility affiliations 10

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1992700371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 FRANKLIN ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054305",
            "telephone_number": "814-534-1555",
            "fax_number": "814-535-8720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 WILLIAM PENN AVE",
            "city": "CONEMAUGH",
            "state": "PA",
            "postal_code": "159091609",
            "telephone_number": "814-322-1519",
            "fax_number": "814-322-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOH",
        "first_name": "JEANMARIE",
        "middle_name": "ATIENZA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-14",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD052897L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001469440",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conemaugh, PA

Sources for this page

Verify at the official NPI Registry.