Active NPI
Nicole Koch
- Medical Physician Assistant
- Kensington, MD
National Provider Identifier
1043463680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- C0003886
- Practice address
- 10400 Connecticut Ave
Ste 606
Kensington, MD 20895-3910 - Phone
- (301) 942-2212
- Fax
- (301) 917-6501
- NPI assigned
- Oct 28, 2008
- Last updated
- Dec 9, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | C0003886 | MD | Primary |
Addresses
Primary practice location
10400 Connecticut Ave
Ste 606
Kensington, MD 20895-3910
Mailing address
2415 Musgrove Rd 3105
Silver Spring, MD 20904-5202
Phone (301) 989-0193
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Potomac Physician Associates | Past | Accepting new patients |
Interoperability endpoints
- nicole.koch@mfmap.eclinicaldirectplus.com
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Silver Spring, MD
- NPI 1972604023
DC
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Family Medicine Physician
- Chevy Chase, MD
- NPI 1831112143
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449619200000",
"number": "1043463680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2415 MUSGROVE RD 3105",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209045202",
"telephone_number": "301-989-0193",
"fax_number": "301-879-2325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10400 CONNECTICUT AVE",
"address_2": "STE 606",
"city": "KENSINGTON",
"state": "MD",
"postal_code": "208953910",
"telephone_number": "301-942-2212",
"fax_number": "301-917-6501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOCH",
"first_name": "NICOLE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-28",
"last_updated": "2015-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MD",
"license": "C0003886",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kensington, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.