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KENNETH KONCILJA M.D.
NPI 1689017543
Internal Medicine in Cleveland, OH

Active since April 10, 2013PECOS Enrolled
9500 EUCLID AVE, CLEVELAND, OH 44195(216) 444-2200(216) 445-6290 Get Directions Write a Review

NPPES record last updated: March 17, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Kenneth Koncilja M.d. NPPES

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

KENNETH KONCILJA M.D. (NPI 1689017543) is an individual internal medicine provider in Cleveland, Ohio, licensed in Ohio (35.128683) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS, is affiliated with Akron General Medical Center, and is a graduate of Toledo Medical College (2013).

NPPES Registry Identity

NPI1689017543
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameKENNETH KONCILJACredential: M.D.
Location Address9500 EUCLID AVECleveland, OH 44195-0001
Mailing Address9500 Euclid AveCleveland, OH 44195-0001 · (216) 444-2200 · Fax (216) 445-6290
Phone(216) 444-2200
Fax(216) 445-6290
Sole ProprietorYes
Medical School CMSToledo Medical CollegeGraduated 2013
Enumeration DateApril 10, 2013
Last NPPES UpdateMarch 17, 2023
NPPES CertifiedMarch 17, 2023
✔ NPI 1689017543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in OH · 35.128683
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
9500 EUCLID AVE, Cleveland, OH 44195
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Antidote Health Plan of Ohio, Inc., Oscar Insurance Corporation of Ohio.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenneth Koncilja M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8921398629
PECOS Enrollment IDI20160825002146
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.

Medicare Billing Reassignment

Medicare enrollment records show Kenneth Koncilja reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

The Cleveland Clinic Foundation
Same address
General Acute Care Hospital
9500 EUCLID AVE
Cleveland, OH 44195
  • Reassigned Medicare billing, Ohio enrollment
  • 7,608 clinicians in this Medicare group
NPI 1679525919 (216) 444-2200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
79 services61 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
60 services52 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
54 services42 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
31 services28 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
24 services24 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
19 services14 patients

Hospital Affiliations CMS Care Compare 5

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

Akron General Medical Center

Acute Care Hospitals · Akron, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360027
Location1 Akron General AvenueAkron, OH 44307 · Summit County
Emergency services Birthing friendly

Fairview Hospital

Acute Care Hospitals · Cleveland, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360077
Location18101 Lorain AvenueCleveland, OH 44111 · Cuyahoga County
Emergency services Birthing friendly

Medina Hospital

Acute Care Hospitals · Medina, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360091
Location1000 East Washington StreetMedina, OH 44256 · Medina County
Emergency services

Cleveland Clinic

Acute Care Hospitals · Cleveland, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360180
Location9500 Euclid AvenueCleveland, OH 44195 · Cuyahoga County
Emergency services Birthing friendly

Hillcrest Hospital

Acute Care Hospitals · Mayfield Heights, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360230
Location6780 Mayfield RoadMayfield Heights, OH 44124 · Cuyahoga County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44195 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
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
2 suppliers19 claims19 services$175.20 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

MS. MARY COLLEEN RATH R.D., L.D., CNSC
Dietitian, Registered
9500 EUCLID AVE, M17
CLEVELAND, OH 44195
Cuyahoga County (216) 444-6986
DR. CHRISTOPHER F TENGGARDJAJA M.D.
Urology (Urogynecology and Reconstructive Pelvic Surgery)
9500 EUCLID AVE, Q10-1
CLEVELAND, OH 44195
Cuyahoga County (216) 444-5600
DR. MASATO FUJIKI M.D., PH.D.
Surgery
9500 EUCLID AVE
CLEVELAND, OH 44195
Cuyahoga County (216) 444-8007
KRISTIN R JOHNSON CNP
Nurse Practitioner
9500 EUCLID AVE
CLEVELAND, OH 44195
Cuyahoga County (800) 223-2273
MONICA LYNN SHEIN CRNA
Nurse Anesthetist, Certified Registered
9500 EUCLID AVE
CLEVELAND, OH 44195
Cuyahoga County (800) 223-2273
MRS. TONYA RENEE GOINGS ACNP-BC
Nurse Practitioner (Acute Care)
9500 EUCLID AVE, SUITE RC25
CLEVELAND, OH 44195
Cuyahoga County (216) 444-2200
MS. DANA ANNE RUBIS CNP
Nurse Practitioner (Critical Care Medicine)
9500 EUCLID AVE, G58
CLEVELAND, OH 44195
Cuyahoga County (216) 444-5086
DR. RACHAEL C SULLIVAN M.D.
Surgery
9500 EUCLID AVE
CLEVELAND, OH 44195
Cuyahoga County (440) 449-1101

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 Kenneth Koncilja's NPI number?

The NPI number for Kenneth Koncilja is 1689017543. It was assigned to this individual provider in the NPPES registry on April 10, 2013.

Where is Kenneth Koncilja located?

Kenneth Koncilja practices at 9500 Euclid Ave, Cleveland, OH 44195. The listed phone number is (216) 444-2200.

What is Kenneth Koncilja's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Kenneth Koncilja enrolled in Medicare?

Yes. Kenneth Koncilja is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kenneth Koncilja's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Koncilja reassigns Medicare benefits to The Cleveland Clinic Foundation (Cleveland, OH). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kenneth Koncilja's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kenneth Koncilja accept?

Health plans from Anthem Blue Cross and Blue Shield, Antidote Health Plan of Ohio, Inc. and Oscar Insurance Corporation of Ohio list Kenneth Koncilja as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kenneth Koncilja affiliated with any hospitals?

According to CMS data, Kenneth Koncilja is affiliated with Akron General Medical Center, Fairview Hospital, Medina Hospital, Cleveland Clinic and Hillcrest Hospital.

When was this NPI record last updated?

The NPPES record for Kenneth Koncilja was last updated on March 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.