JESSE KONG MMS, PA-C - NPI 1396879672 - Physician Assistant in Downers Grove, IL

Q: What is Jesse Kong's NPI number?

The NPI number for Jesse Kong is 1396879672. It was assigned to this individual provider in the NPPES registry on March 16, 2007.

Q: What is Jesse Kong's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Jesse Kong was last updated on March 5, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Jesse Kong Mms, Pa-c NPPES

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

JESSE KONG MMS, PA-C (NPI 1396879672) is an individual surgical provider in Downers Grove, Illinois, licensed in Illinois (085-002627) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS, is affiliated with Advocate Good Samaritan Hospital, and maintains a secondary practice location in Winfield.

NPPES Registry Identity

NPI1396879672

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameJESSE KONGCredential: MMS, PA-C

Location Address3551 HIGHLAND AVE STE 200ADowners Grove, IL 60515-2100

Mailing Address29373 Network PlChicago, IL 60673-1293 · (847) 390-5900

Phone(844) 376-3876

Fax(630) 929-0633

Sole ProprietorNo

Medical School CMSOtherGraduated 2005

Enumeration DateMarch 16, 2007

Last NPPES UpdateMarch 5, 20252 updates tracked since enumeration

NPPES CertifiedMarch 5, 2025

✔ NPI 1396879672 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in IL · 085-002627

3551 HIGHLAND AVE STE 200A, Downers Grove, IL 60515

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Secondary Practice Location 1

Location 125 N Winfield RdWinfield, IL 60190-1295 · Phone (630) 933-4056 · Fax (630) 933-4057

Other Identifiers 2

Other206147256IL · Medicare Ptan (individual)

Other206147IL · Medicare Ptan (group)

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jesse Kong Mms, Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5294833661

PECOS Enrollment IDI20070607000694

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Advocate Good Samaritan Hospital

Acute Care Hospitals · Downers Grove, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140288

Location3815 Highland AvenueDowners Grove, IL 60515 · Du Page County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 7

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

KAYLA ANN HANSON PA-C

Physician Assistant