Mary Beth Koch

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

016331 Issued in NY

Practice address

101 Sterling Dr
Orchard Park, NY 14127-1566

Phone

(716) 675-1022

Fax

(716) 393-1301

NPI assigned

Jan 13, 2015

Last updated

Jan 13, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1366831406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PEACHTREE CT",
            "address_2": "SUITE 105",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414616",
            "telephone_number": "631-467-3700",
            "fax_number": "631-467-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 STERLING DR",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271566",
            "telephone_number": "716-675-1022",
            "fax_number": "716-393-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "MARY BETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-13",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "016331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Kissel-Maute, CPNP
• Joseph T. Kita, MD
• Megan Sara Shumway Kline, FNP-BC
• Knickerbocker Dialysis Inc (Orchard Park Dialysis Center)
• Michelle Wilczek Knoop, OTR/L,CHT
• Christie Leigh Koedel, CPNP
• Mary Katherine Kolbert, MD
• Lindsey N Konst, PA
• Andrew Koroschetz
• Amy Kotarski, DNP

• Physical Therapist in Orchard Park, NY
• Providers in Orchard Park, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.