Dr. Jason Everett Kooch, D.O.
Physical Medicine & Rehabilitation, Pain Medicine in Syosset, NY. Individual provider (NPI-1).
NPI number1902804347
StatusActive
Last updated in NPPESMay 13, 2025
Details
- NPI
- 1902804347
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jason Everett Kooch
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 11, 2005
- Certification date
- May 13, 2025
- Last updated
- May 13, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICAL MEDICINE AND REHABILITATION
- 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 |
|---|---|---|---|---|
| 2081P2900X | Physical Medicine & Rehabilitation, Pain Medicine | 326507 | NY | Yes |
| 208100000X | Physical Medicine & Rehabilitation | OS013001 | PA |
Practice location
115 Eileen WaySyosset, NY 11791-5323
Phone 516-795-3033
Mailing address
115 Eileen WaySyosset, NY 11791-5323
Phone 516-795-3033 · Fax 516-795-3036
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