Individual provider Active NPI

Christian Albert Koch, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Jacksonville, FL
National Provider Identifier
1033156187
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME142358 Issued in FL
Practice address
655 W 8TH St
Jacksonville, FL 32209-6511
Phone
(904) 383-1004
NPI assigned
May 31, 2006
Last updated
May 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 19246 MS
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD469053 PA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME142358 FL Primary

Addresses

Primary practice location

655 W 8TH St
Jacksonville, FL 32209-6511

Mailing address

PO Box 44008
Jacksonville, FL 32231-4008
Phone (904) 383-1004

Other practice location 1

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-2844

Other practice location 2

2500 North State Street
Department of Medicine Division of Endocrinology
Jackson, MS 39216-4500
Phone (601) 984-5525

Other practice location 3

2500 North State Street
Department of Medicine Division of Endocrinology
Jackson, MS 39216-4500
Phone (601) 984-5525

Other identifiers 2

IdentifierTypeStateIssuer
06936861MedicaidMS
P01236774OtherMSRAILROAD MEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191114000232 PA Practitioner - Endocrinology 3072517473 Reassigns benefits to 1 organization
I20230223002841 FL Practitioner - Endocrinology 3072517473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10475 Centurion Pkwy N
Suite 201
Jacksonville, FL 32256-5004
Phone (904) 383-1004

15255 Max Leggett Pkwy
Jacksonville, FL 32218-7213
Phone (904) 383-1000

653 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-1680

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (940) 244-4218

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME142358FLMDEndocrinology, Diabetes & Metabolism Physician
19246MSMDEndocrinology, Diabetes & Metabolism Physician
MD469053PAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc CurrentSince Feb 13, 2021 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Feb 13, 2021 Accepting new patients
University of Florida Jacksonville Physicians Inc Endocrinology, Diabetes & Metabolism CurrentSince Feb 13, 2023 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Feb 13, 2023 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
University Internal Medicine Assoc LLP Past Accepting new patients
University Radiation Oncology Consultants, PLLC Past Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

100 E Lehigh Ave
Philadelphia, PA 19125
Phone (215) 707-1200

2450 W Hunting Park Ave
Philadelphia, PA 19129
Phone (215) 707-2433

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

333 Cottman Ave
#Int
Philadelphia, PA 19111
Phone (215) 728-2844

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

Interoperability endpoints

  • Direct secure messaging: ckoch621059@direct.shands.ufl.edu

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1033156187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-383-1004",
            "fax_number": "904-633-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-383-1004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Cottman Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19111",
            "country_code": "US",
            "telephone_number": "215-728-2844",
            "fax_number": "215-214-1425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 North State Street",
            "address_2": "Department of Medicine Division of Endocrinology",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-5525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 North State Street",
            "address_2": "Department of Medicine Division of Endocrinology",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-5525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCH",
        "first_name": "CHRISTIAN",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MS",
            "license": "19246",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PA",
            "license": "MD469053",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME142358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06936861",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P01236774",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.