Stacey Grum Koff, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

0101058328 Issued in VA

Practice address

8901 Wisconsin Ave
Bethesda, MD 20889-0001

Phone

(301) 319-4769

Fax

(301) 295-4280

NPI assigned

Jan 30, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093851669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10019 KENSINGTON PKWY",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208953430",
            "telephone_number": "301-962-1864",
            "fax_number": "301-295-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001",
            "telephone_number": "301-319-4769",
            "fax_number": "301-295-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOFF",
        "first_name": "STACEY",
        "middle_name": "GRUM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101058328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Noble Kochenderfer, MD
• Paula Nicole Kodosky, DPT
• Erin Elizabeth Koelling, MD
• Elizabeth Koenig
• Katherine Koenig
• Robert Lewis Koffman, MD, MPH
• Sandra Gail Koffman, CRNP
• Christopher Koh, M.D.
• Jacqueline Kohn, CRNP
• Melissa Kokx-Ryan, AU.D., PH.D

• Urology Physician in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Urology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.