Individual provider Active NPI

Donna Marie Koch, D.O.

  • Family Medicine Physician
  • Garfield, NJ
National Provider Identifier
1083652853
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MB069001 Issued in NJ
Practice address
297 Passaic Street
Garfield, NJ 07026
Phone
(973) 777-2293
Fax
(973) 777-9117
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MB069001 NJ Primary

Addresses

Primary practice location

297 Passaic Street
Garfield, NJ 07026

Mailing address

297 Passaic Street
Garfield, NJ 07026
Phone (973) 777-2293

Other identifiers 1

IdentifierTypeStateIssuer
9081101MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160926000141 NJ Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 0547560781 Reassigns benefits to 2 organizations
Practice locations: Garfield, NJ

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heart and Vascular Associates of Northern Jersey, P.a.Group PAC ID 4183610520, 14 clinicians
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

22 -02 Broadway
Suite 201
Fair Lawn, NJ 07410-3016
Phone (201) 475-5050

350 Engle St
Berrie 5
Englewood, NJ 07631-1808
Phone (201) 608-2266

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MB069001NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heart & Vascular Associates of Northern Jersey, P.a. CurrentSince Jun 1, 2025 Accepting new patients
Medical Associates of Englewood, PC CurrentSince Feb 1, 2025 Accepting new patients
HMH Hospitals Corporation Past Accepting new patients

Locations

350 Engle St
#5
Englewood, NJ 07631
Phone (201) 894-3364

22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016

22-18 Broadway
Ste 201
Fair Lawn, NJ 07410

297 Passaic St
#1
Garfield, NJ 07026

297 Passaic St
Garfield, NJ 07026
Phone (973) 365-1338

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

183 Illinois Ave
Paterson, NJ 07503
Phone (973) 523-3400

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EGGJDD/Endpoint/EGGJDD

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1083652853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 PASSAIC STREET",
            "city": "GARFIELD",
            "state": "NJ",
            "postal_code": "07026",
            "telephone_number": "973-777-2293",
            "fax_number": "973-777-9117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 PASSAIC STREET",
            "city": "GARFIELD",
            "state": "NJ",
            "postal_code": "07026",
            "telephone_number": "973-777-2293",
            "fax_number": "973-777-9117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "DONNA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB069001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9081101",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garfield, NJ

Sources for this page

Verify at the official NPI Registry.