Individual provider Active NPI

Erik Charles Kofler, D.O.

  • Anesthesiology Physician
  • Walla Walla, WA
National Provider Identifier
1518387075
Registry record updated Jul 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
OP60758853 Issued in WA
Practice address
401 W Poplar St
Walla Walla, WA 99362-2846
Phone
(855) 600-5163
NPI assigned
Apr 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X OP60758853 WA Primary
Anesthesiology Physician 207L00000X DOL.OL.60473440 WA

Addresses

Primary practice location

401 W Poplar St
Walla Walla, WA 99362-2846

Mailing address

401 W Poplar St
Walla Walla, WA 99362-2846

Other practice location 1

55 W Tietan St
Walla Walla, WA 99362-4445
Phone (509) 522-5174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20180620000219 WA Practitioner - Anesthesiology 4587919303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Service- WashingtonGroup PAC ID 0840279758, 170 clinicians

Practice addresses (Care Compare)

401 W Poplar St
Walla Walla, WA 99362-2846
Phone (509) 897-3320

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.73 of 100Reported as group
Quality
83.21
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DOL.OL.60473440WAMDAnesthesiology Physician
OP60758853WAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Service- Washington Anesthesiology CurrentSince May 21, 2018 Accepting new patients

Locations

101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181

101 W 8th Ave
Bldg 3RD
Spokane, WA 99204

55 W Tietan St
Walla Walla, WA 99362
Phone (509) 525-3720

401 W Poplar St
Walla Walla, WA 99362
Phone (509) 522-5731

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530748800000",
    "number": "1518387075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W POPLAR ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W POPLAR ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622846",
            "telephone_number": "855-600-5163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 W Tietan St",
            "address_purpose": "LOCATION",
            "city": "Walla Walla",
            "state": "WA",
            "postal_code": "993624445",
            "country_code": "US",
            "telephone_number": "509-522-5174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOFLER",
        "first_name": "ERIK",
        "middle_name": "CHARLES",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-23",
        "last_updated": "2018-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "OP60758853",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "DOL.OL.60473440",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

Verify at the official NPI Registry.