Individual provider Active NPI

Diane Koch, PT

  • Orthopedic Physical Therapist
  • Newport Beach, CA
National Provider Identifier
1245256148
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT9997 Issued in CA
Practice address
351 Hospital Rd
Suite 606
Newport Beach, CA 92663-3509
Phone
(949) 650-3870
Fax
(949) 650-2544
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT9997 CA Primary

Addresses

Primary practice location

351 Hospital Rd
Suite 606
Newport Beach, CA 92663-3509

Mailing address

351 Hospital Rd
Suite 606
Newport Beach, CA 92663-3509
Phone (949) 650-3870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120201000027 CA Practitioner - Physical Therapist in Private Practice 5193982262 Practice locations: Newport Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

351 Hospital Rd
Suite 606
Newport Beach, CA 92663-3508
Phone (949) 650-3870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT9997CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Diane Koch RPT Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245256148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 HOSPITAL RD",
            "address_2": "SUITE 606",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633509",
            "telephone_number": "949-650-3870",
            "fax_number": "949-650-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 HOSPITAL RD",
            "address_2": "SUITE 606",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633509",
            "telephone_number": "949-650-3870",
            "fax_number": "949-650-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT9997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • 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.
  • 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.