Organization Active NPI

Lear Von Koch MD & Associates

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Scranton, PA
National Provider Identifier
1457422768
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
LEAR VON KOCH MD & ASSOCIATES
Practice address
720 Madison Ave
Scranton, PA 18510-1609
Phone
(570) 343-1115
NPI assigned
Nov 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Lear Von Koch, M.D.NPI 1487725891
Title
President
Phone
(570) 343-1115

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208G00000X Primary

Addresses

Primary practice location

720 Madison Ave
Scranton, PA 18510-1609

Mailing address

720 Madison Ave
Scranton, PA 18510-1609
Phone (570) 343-1115

Other identifiers 1

IdentifierTypeStateIssuer
0008913210002MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031204000014 PA Part B Supplier - Clinic/Group Practice 1850296716 Receives reassigned benefits from 1 practitioner
Practice locations: Scranton, PA

National Provider Directory

National Provider Directory

Locations

720 Madison Ave
Scranton, PA 18510
Phone (570) 343-1115

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457422768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 MADISON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185101609",
            "telephone_number": "570-343-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 MADISON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185101609",
            "telephone_number": "570-343-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAR VON KOCH MD & ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "LEAR",
        "authorized_official_middle_name": "VON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-343-1115",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008913210002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.