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JONATHAN MARK KOROSTOFF DMD
NPI 1154358042
Dentist - Periodontics in Philadelphia, PA

Active since June 27, 2006PECOS Enrolled
3400 SPRUCE ST, 5 WHITE BUILDING, PHILADELPHIA, PA 19104(215) 662-3580 Get Directions Write a Review

NPPES record last updated: April 2, 2013. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Jonathan Mark Korostoff Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JONATHAN MARK KOROSTOFF DMD (NPI 1154358042) is an individual periodontics provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (DS024789L) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154358042
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameJONATHAN MARK KOROSTOFFCredential: DMD
Location Address3400 SPRUCE ST, 5 WHITE BUILDINGPhiladelphia, PA 19104-4206
Mailing Address3400 Spruce St, 5 White BuidingPhiladelphia, PA 19104-4206 · (215) 662-3580
Phone(215) 662-3580
Sole ProprietorNo
Enumeration DateJune 27, 2006
Last NPPES UpdateApril 2, 2013
✔ NPI 1154358042 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in PA · DS024789L
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
3400 SPRUCE ST, Philadelphia, PA 19104
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Other Identifiers 3

Medicaid0014770200001PA
Medicare UPINU42313
Medicare PIN206406PA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jonathan Mark Korostoff Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$92.69 typical visit price
range $59.88 – $180.99
Typical copayment $23.17 (range $14.97 – $45.24)
Most-billed visit code 99203
Established Patient
$74.47 typical visit price
range $19.30 – $147.29
Typical copayment $18.61 (range $4.82 – $36.82)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIZABETH FOGLIA MD
Pediatrics
3400 SPRUCE ST, 8 RAVDIN
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-3228
JOEL M STEIN MD
Radiology (Diagnostic Radiology)
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-3005
PRISCILLA NELSON M.D.
Anesthesiology
3400 SPRUCE ST, 6 DULLES
PHILADELPHIA, PA 19104
Philadelphia County (215) 349-8310
DR. JASON THOMAS ACKRIVO MD
Internal Medicine (Pulmonary Disease)
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 614-0871
JEAN-PHILIPPE RICHARD DMD
Student in an Organized Health Care Education/Training Program
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-6176
LEAH M LOPEZ PA-C
Physician Assistant (Medical)
3400 SPRUCE ST, 4 SILVERSTEIN
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-7870
JOANIE M GARRATT MD
Radiology (Diagnostic Radiology)
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-3000
JENNIFER DEKERLEGAND
Physical Therapist
3400 SPRUCE ST, 1 WHITE BUILDING
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-3265

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Korostoff's NPI number?

The NPI number for Jonathan Korostoff is 1154358042. It was assigned to this individual provider in the NPPES registry on June 27, 2006.

Where is Jonathan Korostoff located?

Jonathan Korostoff practices at 3400 Spruce St 5 White Building, Philadelphia, PA 19104. The listed phone number is (215) 662-3580.

What is Jonathan Korostoff's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Jonathan Korostoff enrolled in Medicare?

Yes. Jonathan Korostoff is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jonathan Korostoff was last updated on April 2, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.