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JONATHAN KHERSONSKY M.D.
NPI 1891007456
Student in an Organized Health Care Education/Training Program in Emeryville, CA

Active since July 11, 2010PECOS EnrolledAccepts Medicare Assignment
6363 CHRISTIE AVE APT 614, EMERYVILLE, CA 94608(510) 437-4902 Get Directions Write a Review

NPPES record last updated: February 11, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jonathan Khersonsky M.d. NPPES

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

JONATHAN KHERSONSKY M.D. (NPI 1891007456) is an individual student in an organized health care education/training program in Emeryville, California and active in the NPI registry since July 2010. He is enrolled in Medicare PECOS and is a graduate of New York Medical College (2010).

NPPES Registry Identity

NPI1891007456
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJONATHAN KHERSONSKYCredential: M.D.
Location Address6363 CHRISTIE AVE APT 614Emeryville, CA 94608-1917
Mailing Address6363 Christie Ave Apt 614Emeryville, CA 94608-1917
Phone(510) 437-4902
Sole ProprietorYes
Medical School CMSNew York Medical CollegeGraduated 2010
Enumeration DateJuly 11, 2010
Last NPPES UpdateFebruary 11, 2022
✔ NPI 1891007456 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
6363 CHRISTIE AVE APT 614, Emeryville, CA 94608
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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

Jonathan Khersonsky M.d. 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 ID9133441447
PECOS Enrollment IDI20141121002378
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.

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 Khersonsky's NPI number?

The NPI number for Jonathan Khersonsky is 1891007456. It was assigned to this individual provider in the NPPES registry on July 11, 2010.

Where is Jonathan Khersonsky located?

Jonathan Khersonsky practices at 6363 Christie Ave Apt 614, Emeryville, CA 94608. The listed phone number is (510) 437-4902.

What is Jonathan Khersonsky's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jonathan Khersonsky enrolled in Medicare?

Yes. Jonathan Khersonsky is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jonathan Khersonsky was last updated on February 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.