Individual provider Active NPI

Kirsten Koch, MD

  • Family Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1568857316
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-133807 Issued in OH
Practice address
3805 Edwards Rd Ste 360
Cincinnati, OH 45209
Phone
(513) 871-7848
Fax
(513) 871-3278
NPI assigned
Mar 30, 2015
Last updated
Oct 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-133807 OH Primary

Addresses

Primary practice location

3805 Edwards Rd Ste 360
Cincinnati, OH 45209

Mailing address

3805 Edwards Rd Ste 360
Cincinnati, OH 45209-1934
Phone (513) 871-7848

Other identifiers 2

IdentifierTypeStateIssuer
0288732MedicaidOH
7100537860MedicaidKY

Other names 1

  • Kirsten Lange Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kkoch57061@direct.thechristhospital.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180911000232 OH Practitioner - Family Practice 0941550065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Christ Hospital Medical Associates, LLCGroup PAC ID 0244314102, 270 clinicians

Practice addresses (Care Compare)

3805 Edwards Rd
Suite 360
Cincinnati, OH 45209-1940
Phone (513) 871-7848

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-133807OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Christ Hospital Medical Associates, LLC Family Medicine CurrentSince Sep 24, 2018 Accepting new patients
The Christ Hospital Medical Associates, III CurrentSince Apr 25, 2022 Accepting new patients
Christ Hospital Orthopedic Associates III LLC Past Accepting new patients

Locations

2123 Auburn Ave
#200
Cincinnati, OH 45219
Phone (513) 321-0833

3805 Edwards Rd
Ste 360
Cincinnati, OH 45209
Phone (513) 321-0833

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1568857316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 EDWARDS RD STE 360",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452091934",
            "telephone_number": "513-871-7848",
            "fax_number": "513-871-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 EDWARDS RD STE 360",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45209",
            "telephone_number": "513-871-7848",
            "fax_number": "513-871-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "KIRSTEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-133807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0288732",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100537860",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkoch57061@direct.thechristhospital.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3805 Edwards Rd Ste 360",
            "city": "Cincinnati",
            "state": "OH",
            "country_code": "US",
            "postal_code": "45209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIRSTEN",
            "last_name": "LANGE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.