NPIMap

Individual provider Active NPI

Enrique Koh, MD

  • Family Medicine Physician
  • Ebensburg, PA
National Provider Identifier
1184629552
Registry record updated Mar 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD052898L Issued in PA
Practice address
1100 W High St
Ebensburg, PA 15931-1706
Phone
(814) 472-7933
Fax
(814) 472-2301
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2014

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 MD052898L PA Primary

Addresses

Primary practice location

1100 W High St
Ebensburg, PA 15931-1706

Mailing address

1086 Franklin St
Johnstown, PA 15905-4305
Phone (814) 410-8300

Other identifiers 1

IdentifierTypeStateIssuer
0014671780003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100517000096 PA Practitioner - Family Practice 9638207434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DLP Conemaugh Physician Practices LLCGroup PAC ID 7315166949, 286 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

1111 Franklin St
Johnstown, PA 15905-4341

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

861 Hills PLZ
Ebensburg, PA 15931-4211

Hospital & facility affiliations

  • Conemaugh Home Health Home health agency, Johnstown, PA, CCN 397406
  • Heartland Hospice Hospice, Pittsburgh, PA, CCN 391610
  • Conemaugh Memorial Medical Center Hospital, Johnstown, PA, CCN 390110
  • Upmc Altoona Hospital, Altoona, PA, CCN 390073
  • Conemaugh Miners Medical Center Hospital, Hastings, PA, CCN 391317

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Conemaugh Physician Practices LLC CurrentSince Sep 1, 2014 Accepting new patients
DLP Conemaugh Physician Practices LLC Family Medicine Current Accepting new patients
DLP Conemaugh Physician Practices LLC Family Medicine CurrentSince Sep 1, 2014 Accepting new patients
Conemaugh Health Initiatives Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

861 Hills Plz
Ste 140
Ebensburg, PA 15931
Phone (814) 471-9005

236 Jamesway Rd
Ebensburg, PA 15931
Phone (814) 471-6595

1020 Franklin St
Johnstown, PA 15905
Phone (814) 533-1095

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

1086 Franklin St
Bldg G
Johnstown, PA 15905
Phone (914) 534-9000

1450 Scalp Ave
Johnstown, PA 15904
Phone (814) 266-1189

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

Interoperability endpoints

  • Direct secure messaging: ekoh6658@direct.conemaugh.org

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 8

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1184629552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 FRANKLIN ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054305",
            "telephone_number": "814-410-8300",
            "fax_number": "814-410-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W HIGH ST",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159311706",
            "telephone_number": "814-472-7933",
            "fax_number": "814-472-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOH",
        "first_name": "ENRIQUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD052898L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014671780003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ebensburg, PA

Sources for this page

Verify at the official NPI Registry.