Nicole F Koba, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

7621000632 Issued in DC

Practice address

2100 Pennsylvania Ave NW
4TH Floor
Washington, DC 20037-3202

Phone

(202) 529-5200

Fax

(202) 269-3462

NPI assigned

Sep 25, 2006

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC, Optometrist

  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD
• Capital Eye Physicians & Surgeons LLC

  • Ophthalmology Physician
  • Bowie, MD
  • NPI 1245247840
  NPD (past)
• Capital Eye Physicians & Surgeons, LLC

  • Ophthalmology Physician
  • Bowie, MD
  • NPI 1154451219
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1558461012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 PENNSYLVANIA AVE NW",
            "address_2": "4TH FLOOR",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200373202",
            "telephone_number": "202-872-7247",
            "fax_number": "202-872-7296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 PENNSYLVANIA AVE NW",
            "address_2": "4TH FLOOR",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200373202",
            "telephone_number": "202-529-5200",
            "fax_number": "202-269-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBA",
        "first_name": "NICOLE",
        "middle_name": "F",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "DA1177",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DC",
            "license": "7621000632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2100 Pennsylvania Ave NW",
            "address_2": "4th Floor",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200373202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2100 Pennsylvania Ave NW",
            "address_2": "4th Floor",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200373202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Ko
• Judith June Ko
• Marthe Fouondzing Koanou
• Wei Li Adeline Koay
• Amanda Alexis Koba, LMSW
• Ihori Kobayashi, PH.D.
• Viviane Sarah Kobea
• Aaminah Kobeisy, MD
• Hannah Kobett, PA-C
• Arthur Irwin Kobrine, M.D.,PH.D.

• Optometrist in Washington, DC
• Providers in Washington, DC by specialty
• Optometrist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.