Anita R. Koch, RN CNS

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

NS09826 Issued in OH

Practice address

7067 Tiffany Blvd
Suite 230
Poland, OH 44514-1993

Phone

(330) 758-2748

Fax

(330) 758-3282

NPI assigned

Oct 31, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Clinical Nurse Specialist (CNS)

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Triad Health Services LLCGroup PAC ID 9032367917, 252 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Surgical Hospital at Southwoods Hospital, Youngstown, OH, CCN 360352
• HMHP St Elizabeth Boardman Health Center Hospital, Boardman, OH, CCN 360276

Merit-based Incentive Payment System (MIPS)

Final score

83.94 of 100Reported as group

Quality

71.12

Promoting interoperability

100

Improvement activities

40

Cost

75.36

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Master of Science, Registered Nurse

State licenses

Practice roles

Locations

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.

• Triad Health Services, LLC

  • Plastic Surgery Physician
  • Youngstown, OH
  • NPI 1588925457
  Medicare reassignment Care Compare group NPD
• Bel-Park Anesthesia Associates, Inc.

  • Anesthesiology Physician
  • Youngstown, OH
  • NPI 1508813528
  Medicare reassignment NPD
• Northeast Ohio Cardiovascular Specialists Inc.

  • Cardiovascular Disease Physician
  • Akron, OH
  • NPI 1538176136
  NPD (past)
• The Surgery Center at Southwoods, LLC

  • Special Hospital
  • Youngstown, OH
  • NPI 1740398890
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Health Youngstown LLC

  • General Acute Care Hospital
  • Youngstown, OH
  • NPI 1790868982
  Care Compare affiliation
• The Surgery Center at Southwoods, LLC

  • Special Hospital
  • Youngstown, OH
  • NPI 1740398890
  Care Compare affiliation

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

{
    "created_epoch": "1225411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498089600000",
    "number": "1316190556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 BOARDMAN CANFIELD RD",
            "address_2": "SUITE 101",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069803",
            "telephone_number": "330-286-5330",
            "fax_number": "330-286-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7067 TIFFANY BLVD",
            "address_2": "SUITE 230",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445141993",
            "telephone_number": "330-758-2748",
            "fax_number": "330-758-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "ANITA",
        "middle_name": "R.",
        "name_prefix": "Mrs.",
        "credential": "RN CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-31",
        "last_updated": "2017-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN. 226436",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "OH",
            "license": "NS09826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BSBS",
            "identifier": "000000955776",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2916518",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H155462",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna J Kempe, CRNA
• Cassidy Morgan Keyser, CNP
• Chotikorn Khunnawat, M.D.
• April Lynn Kirkwood, LPC
• David Michael Klacik, CNP
• Jason Joseph Koenig, NP-C
• Angelo John Kostas, RD
• James N Kozlow, D.D.S
• James J. Krumpak III, DC
• Kruti Internal Medicine

• Adult Health Clinical Nurse Specialist in Poland, OH
• Providers in Poland, OH by specialty
• Adult Health Clinical Nurse Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2017; 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.