Individual provider Active NPI

Michael Kouch, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Camden, NJ
National Provider Identifier
1174870604
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
25MA10093500 Issued in NJ
Practice address
1 Cooper PLZ
Camden, NJ 08103
Phone
(856) 342-2000
NPI assigned
Aug 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD454906 PA
Emergency Medicine Physician 207P00000X MT202234 PA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 25MA10093500 NJ Primary

Addresses

Primary practice location

1 Cooper PLZ
Camden, NJ 08103

Mailing address

1 Federal St # 200
Camden, NJ 08103-1088
Phone (856) 356-4924

Other practice location 1

3998 Red Lion Rd
Philadelphia, PA 19114-1445
Phone (215) 612-4963

Other practice location 2

3998 Red Lion Rd
Philadelphia, PA 19114-1445
Phone (215) 612-4963

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
I20190821004105 NJ Practitioner - Critical Care (Intensivists) 3577876531 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Temple University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Care, Inc.Group PAC ID 9335040419, 126 clinicians

Practice addresses (Care Compare)

1 Cooper PLZ
Camden, NJ 08103-1461
Phone (856) 342-2633

335 Delsea Dr N
Glassboro, NJ 08028-1403
Phone 85645147002755

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT202234PAMDEmergency Medicine Physician
25MA10093500NJMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Department of Medicine Group PA Critical Care Medicine CurrentSince Jul 1, 2019 Accepting new patients
CMC Department of Medicine Group PA CurrentSince Jul 1, 2019 Accepting new patients
Community Health Care, Inc. CurrentSince May 26, 2024 Accepting new patients
Community Health Care, Inc. CurrentSince May 26, 2024 Accepting new patients
Inspira Medical Centers, Inc. Past Accepting new patients

Locations

30 N Pearl St
Bridgeton, NJ 08302

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

1 Federal St
#200
Camden, NJ 08103

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

3 Cooper Plz
Rm 215
Camden, NJ 08103
Phone (856) 342-2439

2 Stone Harbor Blvd
Cape May Court House, NJ 08210
Phone (609) 463-2000

335 Delsea Dr N
Glassboro, NJ 08028
Phone (856) 863-5720

309 Bridgeboro Rd
Moorestown, NJ 08057
Phone (856) 439-2000

700 Mullica Hill Rd
Mullica Hill, NJ 08062
Phone (856) 508-1000

65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414

310 Salem Woodstown Rd
Salem, NJ 08079
Phone (856) 339-6054

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

509 N Broad St
Woodbury, NJ 08096
Phone (856) 686-5396

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 7

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": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1174870604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "08103",
            "telephone_number": "856-342-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3998 Red Lion Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191141445",
            "country_code": "US",
            "telephone_number": "215-612-4963",
            "fax_number": "215-612-4532",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3998 Red Lion Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191141445",
            "country_code": "US",
            "telephone_number": "215-612-4963",
            "fax_number": "215-612-4532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOUCH",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-15",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD454906",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT202234",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NJ",
            "license": "25MA10093500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.