Individual provider Active NPI

Arash Koochek, M.D.

  • Dermatology Physician
  • West Dundee, IL
National Provider Identifier
1477720472
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
01073107A Issued in IN
Practice address
1201 Water Tower Rd
West Dundee, IL 60118-3330
Phone
(847) 851-8888
NPI assigned
May 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 036132565 IL
Dermatology Physician 207N00000X 050641 CT
Dermatology Physician 207N00000X 01073107A IN Primary

Addresses

Primary practice location

1201 Water Tower Rd
West Dundee, IL 60118-3330

Mailing address

1201 Water Tower Rd
West Dundee, IL 60118-3330
Phone (847) 851-8888

Other identifiers 1

IdentifierTypeStateIssuer
004235900MedicaidCT

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20171018001186 AZ Practitioner - Dermatology 9830350891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Vermont College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Physician Specialists Arizona LLCGroup PAC ID 6204002272, 371 clinicians

Practice addresses (Care Compare)

14416 W Meeker Blvd
Sun City, AZ 85375-5284
Phone (623) 876-3800

Merit-based Incentive Payment System (MIPS)

Final score
84.12 of 100Reported as group
Quality
76.35
Promoting interoperability
99
Improvement activities
40
Cost
71.55

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1420
Removal or shaving of skin growth526
Skin biopsy661

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036132565ILMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC CurrentSince Jul 19, 2017 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Jul 19, 2017 Accepting new patients
Banner Physician Specialists Arizona LLC Current Accepting new patients

Locations

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

14416 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 583-5083

Organizations & group practices 3

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": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1477720472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 WATER TOWER RD",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601183330",
            "telephone_number": "847-851-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 WATER TOWER RD",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601183330",
            "telephone_number": "847-851-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOCHEK",
        "first_name": "ARASH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-09",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036132565",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "050641",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01073107A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235900",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Dundee, IL

Sources for this page

Verify at the official NPI Registry.