Cody A Koch, MD, PHD

Primary specialty

Plastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianTaxonomy code 2082S0099X

License

40814 Issued in IA

Practice address

4855 Mills Civic Pkwy
West Des Moines, IA 50265-5268

Phone

(515) 277-5555

NPI assigned

Jun 5, 2007

Last updated

Nov 30, 2014By 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 2

Medicare fee-for-service enrollment

Enrolled in IA

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

Plastic and Reconstructive Surgery

Education

Mayo Medical School, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Koch Facial Plastic Surgery PCGroup PAC ID 7012909781, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

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.

• Koch Facial Plastic Surgery PC

  • Otolaryngology Physician
  • West Des Moines, IA
  • NPI 1316389653
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417305600000",
    "number": "1316149925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 MILLS CIVIC PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502655268",
            "telephone_number": "515-277-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 MILLS CIVIC PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502655268",
            "telephone_number": "515-277-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "CODY",
        "middle_name": "A",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2014-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "IA",
            "license": "40814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316149925",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0293193",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Knoblauch, DO
• Scott Joseph Knoer, RPH
• Koch Facial Plastic Surgery PC
• Brenton B Koch, MD
• Cameron Mansfield Koch, MD
• Ian Koch, D.O.
• Nathan Koch
• Micaela Marie Koci, MD
• Kristopher Koehler
• Kalyssa Rose Koehn

• Plastic Surgery Physician in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Plastic Surgery Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2014; 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.