Jonathan Khersonsky, M.D.
Student in an Organized Health Care Education/Training Program in Emeryville, CA. Individual provider (NPI-1).
NPI number1891007456
StatusActive
Last updated in NPPESFeb 11, 2022
Details
- NPI
- 1891007456
- Entity type
- Individual (NPI-1)
- Name
- Jonathan Khersonsky
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 11, 2010
- Last updated
- Feb 11, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - ANESTHESIOLOGY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
6363 Christie Ave Apt 614Emeryville, CA 94608-1917
Phone 510-437-4902
Mailing address
6363 Christie Ave Apt 614Emeryville, CA 94608-1917
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Student in an Organized Health Care Education/Training Program providers in Emeryville, CA
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- Isheh BeckNPI 1093232720
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- Andrew Phillip Corwin, MANPI 1275966830
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- Brigette Adair Stump-VernonNPI 1073862652
All 8 Student in an Organized Health Care Education/Training Program providers in Emeryville · All 827 providers in Emeryville
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