Theodore Koh, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

226613 Issued in NY

Practice address

260 Township Blvd
Ste 20
Camillus, NY 13031-1674

Phone

(315) 708-0091

Fax

(315) 708-0194

NPI assigned

Jul 28, 2006

Last updated

Jun 17, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Gastroenterology

Education

Harvard Medical School, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associated Gastroenterologists of Central New York PCGroup PAC ID 3375512213, 14 clinicians

St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph's Hospital Health Center Hospital, Syracuse, NY, CCN 330140
• University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drtkoh@agcny.medentdirect.com
• Direct secure messaging: tkoh2386957@direct.trinity-health.org

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.

• St Josephs Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1942501747
  Medicare reassignment Care Compare group NPD
• Associated Gastroenterologists of Central New York, PC

  • Gastroenterology Physician
  • Camillus, NY
  • NPI 1013938174
  Medicare reassignment Care Compare group
• North Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1972563070
  NPD
• Agcny East LLC

  dba Endoscopy Center of Central New York

  • Ambulatory Surgical Clinic/Center
  • Fayetteville, NY
  • NPI 1801196050
  NPD (past)
• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373
  NPD (past)

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

• St Josephs Hospital Health Center

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1508815333
  Care Compare affiliation
• Suny Health Science Center at Syracuse

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1578554630
  Care Compare affiliation

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1114931037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 TOWNSHIP BLVD",
            "address_2": "STE 20",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311674",
            "telephone_number": "315-708-0190",
            "fax_number": "315-488-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 TOWNSHIP BLVD",
            "address_2": "STE 20",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311674",
            "telephone_number": "315-708-0091",
            "fax_number": "315-708-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOH",
        "first_name": "THEODORE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "226613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02335344",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chong Ki Kim, RPH
• Erin Elizabeth Kintner, FNP-C
• Richard Knezovich, PT
• Alexander Brian Knudsen, M.D.
• Renee Koch, PTA
• Lawrence W Krieger, MD
• Kristin Botwinick LCSW-R
• Ladislava Kulikova, FNP
• Sungeun Kwak
• Laboratory Corporation of America Holdings

• Gastroenterology Physician in Camillus, NY
• Providers in Camillus, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.