Jacob John Koczman, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

66739 Issued in AZ

Practice address

14256 N Northsight Blvd Ste 120
Scottsdale, AZ 85260-3954

Phone

(623) 249-7589

NPI assigned

Jul 2, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in CO, AZ2 enrollments

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 2

Specialty

Ophthalmology

Education

University of Iowa, RJ & L Carver College of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brandon Suedekum MD, PCGroup PAC ID 3779915558, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.65 of 100Reported as group

Quality

98.47

Improvement activities

40

Cost

77.53

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkoczman@suedekum.intellechartdirect.net

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.

• Brandon Suedekum MD, PC

  • Ophthalmology Physician
  • Scottsdale, AZ
  • NPI 1487204442
  Medicare reassignment Care Compare group NPD
• Samuel Jeng, M.D., P.C.

  • Ophthalmology Physician
  • Greeley, CO
  • NPI 1821356163
  Medicare reassignment
• Total Vision Eye Care Group LLC

  • Ophthalmology Physician
  • Basalt, CO
  • NPI 1568248243
  NPD (past)

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1194988980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14256 N NORTHSIGHT BLVD STE 120",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603954",
            "telephone_number": "623-249-7589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14256 N NORTHSIGHT BLVD STE 120",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603954",
            "telephone_number": "623-249-7589"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12647 W Smokey Dr Ste 115",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853783799",
            "country_code": "US",
            "telephone_number": "623-249-7589",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "595 N Dobson Rd Ste A-15",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852244226",
            "country_code": "US",
            "telephone_number": "623-249-7589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCZMAN",
        "first_name": "JACOB",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "11014550A",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "274908",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "DR.0056977",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "11014550A",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "66739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy V Koch, MD
• Nathan Quinten Koch, P.T.
• Nicole C. Koch, PT, DPT
• Robert James Koch, DMD
• Genevie Loree Kocourek, M.D.
• Kaitlin Koczman
• Koda Plastic Surgery
• Lavanya Kodali, MD
• Syed Matthew Kodilinye, MBBS
• Tony James Koehler, DC

• Ophthalmology Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Ophthalmology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; 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.