MR. JESSE DONALD KOSIBA PH.D.
NPI 1760043632
Psychologist - Clinical in Newton, MA
- Individual
- Male
- Psychologist
- Clinical
- Opted-Out Medicare
About JESSE KOSIBA
This page provides the complete NPI Profile along with additional information for Jesse Kosiba, a provider established in Newton, Massachusetts with a medical specialization in Psychologist, focusing in clinical . The healthcare provider is registered in the NPI registry with number 1760043632 assigned on June 2019. The practitioner's primary taxonomy code is 103TC0700X with license number 11743 (MA). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1760043632 Verify this NPI
- Provider Name
- MR. JESSE DONALD KOSIBA PH.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1075 WASHINGTON ST NEWTON, MA 02465
- Location Phone
- (508) 876-7202
- Mailing Address
- 1075 WASHINGTON ST NEWTON, MA 02465
- Mailing Phone
- (508) 876-7202
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-21-2019
- Last Update Date
- 02-27-2024
- Code Navigator
A clinical psychologist like Jesse Kosiba assesses, diagnoses, and treats mental, emotional, and behavioral disorders. Clinical psychologists help people deal with problems ranging from short-term personal issues to severe, chronic conditions. Clinical psychologists interview patients, give diagnostic tests, provide psychotherapy and design behavior modification programs to help patients.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Jesse Kosiba opted out of Medicare effective on 08-30-2022 until 08-30-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist Clinical
- Taxonomy Code
- 103TC0700X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 11743
- License State
- MA
- Taxonomy Description
- A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 08-30-2022
Opt-Out End Date: 08-30-2026
Eligible to Order and Refer? No
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Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
WEST NEWTON, MA 02465
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1760043632, enumerated as an "individual" on June 21, 2019.
The provider is located at 1075 WASHINGTON ST NEWTON, MA 02465 and the phone number is (508) 876-7202.
Psychologist with taxonomy code 103TC0700X and a focus in Clinical.
