NPIMap

Individual provider Active NPI

Imad George Koj, M.D.

  • Infectious Disease Physician
  • Terre Haute, IN
National Provider Identifier
1073503207
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
01048808A Issued in IN
Practice address
3903 S 7TH St
Ste 2E
Terre Haute, IN 47802-5710
Phone
(812) 235-7370
Fax
(812) 235-7570
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 01048808A IN Primary

Addresses

Primary practice location

3903 S 7TH St
Ste 2E
Terre Haute, IN 47802-5710

Mailing address

3903 S 7TH St Ste 2E
Terre Haute, IN 47802-5710
Phone (812) 235-7370

Other identifiers 3

IdentifierTypeStateIssuer
000000389741OtherINANTHEM PIN
200230910MedicaidIN
P00283648OtherINRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051029000112 IN Practitioner - Internal MedicinePractitioner - Infectious Disease 0042237984 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union Hospital IncGroup PAC ID 8426943614, 90 clinicians

Practice addresses (Care Compare)

1606 N 7TH St
Terre Haute, IN 47804-2706

3903 S 7TH St
Terre Haute, IN 47802-5710

Hospital & facility affiliations

  • Visiting Nurse Association of the Wabash Valley in Home health agency, Terre Haute, IN, CCN 157015
  • Elara Caring Home health agency, Kokomo, IN, CCN 157586
  • Amedisys Home Health Home health agency, Bloomington, IN, CCN 157578
  • Union Hospital Inc Hospital, Terre Haute, IN, CCN 150023
  • Sullivan County Community Hospital Hospital, Sullivan, IN, CCN 151327
  • Ascension St Vincent Clay Hospital, Brazil, IN, CCN 151309
  • Paris Community Hospital Hospital, Paris, IL, CCN 141320
  • Union Hospital Clinton Hospital, Clinton, IN, CCN 151326

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01048808AINMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Group LLC CurrentSince Oct 1, 2005 Accepting new patients
Union Hospital, Inc. CurrentSince Sep 1, 2011 Accepting new patients
Union Hospital, Inc. CurrentSince Sep 1, 2011 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Union Hospital Inc. Past Accepting new patients

Locations

801 S Main St
Clinton, IN 47842
Phone (765) 832-1212

3903 S 7th St
Ste 2E
Terre Haute, IN 47802
Phone (812) 235-7370

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

2723 S 7th St
Ste A
Terre Haute, IN 47802
Phone (812) 238-1730

Organizations & group practices 5

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

Hospital & facility affiliations 12

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1073503207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 S 7TH ST STE 2E",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478025710",
            "telephone_number": "812-235-7370",
            "fax_number": "812-235-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 S 7TH ST",
            "address_2": "STE 2E",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478025710",
            "telephone_number": "812-235-7370",
            "fax_number": "812-235-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOJ",
        "first_name": "IMAD",
        "middle_name": "GEORGE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IN",
            "license": "01048808A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000389741",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200230910",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00283648",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.