JONATHAN KHERSONSKY M.D.
NPI 1891007456
Student in an Organized Health Care Education/Training Program in Emeryville, CA
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
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignment
Medicare enrollment records show Jonathan Khersonsky reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Richmond, CA 94801
- Reassigned Medicare billing, California enrollment
- 20,078 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Which organization bills Medicare for Jonathan Khersonsky's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jonathan Khersonsky reassigns Medicare benefits to Permanente Medical Group Inc (Richmond, CA). 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 Jonathan Khersonsky's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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.
# Jonathan Khersonsky, M.D. · NPI 1891007456
Student in an Organized Health Care Education/Training Program provider in Emeryville, California. Individual provider, active in the CMS NPPES registry since July 11, 2010.
## Identity
- **NPI:** 1891007456 (Entity type: Individual)
- **Enumerated:** July 11, 2010
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 6363 CHRISTIE AVE APT 614, Emeryville, CA 94608-1917
- **Phone:** (510) 437-4902
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Permanente Medical Group Inc (NPI 1235226531, Richmond, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** New York Medical College, class of 2010
## Record status
- **NPPES last updated:** February 11, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1891007456) · Data from the CMS NPPES public registry.