Individual
DR. JASON EVERETT KOOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
115 EILEEN WAY, SYOSSET, NY 11791-5323
(516) 795-3033
Mailing address
115 EILEEN WAY, SYOSSET, NY 11791-5323
(516) 795-3033
(516) 795-3036
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
OS013001
PA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
326507
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011608520001
—
PA
01
—
1622793
HIGHMARK BLUE SHIELD
—
01
—
2170526
MAMSI
—
01
—
2299715000
INDEPENDENCE BLUE CROSS
—
01
—
2458473
UNITED HEALTHCARE
—
01
—
397414
HEALTH AMERICA/HEALTH ASS
—
01
—
50044478
KEYSTONE HEALTH CENTRAL
—
01
—
6432850
CIGNA HEALTHCARE
—
01
—
7466584
AETNA PPO
—
01
—
821131
FIRST PRIORITY HEALTH
—
01
—
90338
GEISINGER HEALTH PLAN
—
01
—
P00230776
RAILROAD MEDICARE
—
01
—
P3356842
OXFORD HEALTH PLANS
—
Enumeration date
07/11/2005
Last updated
05/13/2025
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