John M Koller, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

S3737 Issued in AK

Practice address

202 Center Ave.
Ste. 102
Kodiak, AK 99615-1126

Phone

(907) 486-6188

Fax

(907) 486-6146

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AK

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

Specialty

Family Practice

Education

University of Minnesota Medical School, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Kodiak Island Medical Ctr Hospital, Kodiak, AK, CCN 021306

Merit-based Incentive Payment System (MIPS)

Final score

76.58 of 100Reported as group

Quality

74.05

Improvement activities

40

Cost

56.66

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.koller.1@8408.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/8408/brand/1/csg/1/fhir/r4

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.

• Kodiak Island Ambulatory Care Clinic Inc.

  • Urgent Care Clinic/Center
  • Kodiak, AK
  • NPI 1366596504
  Medicare reassignment NPD Authorized official

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

• Providence Health & Services Washington

  dba Providence Kodiak Island Medical Center

  • Critical Access Hospital
  • Kodiak, AK
  • NPI 1013905660
  Care Compare affiliation

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515542400000",
    "number": "1588721195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1126",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996151126",
            "telephone_number": "907-486-6188",
            "fax_number": "907-486-6146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 CENTER AVE.",
            "address_2": "STE. 102",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996151126",
            "telephone_number": "907-486-6188",
            "fax_number": "907-486-6146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLER",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2018-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "3737",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "S3737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID ( DEACTIVATED AFTER 5.16.09)",
            "identifier": "K151630",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD10072",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID 6.29.09 - PRESENT",
            "identifier": "K162501",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kodiak Island Health Care Foundation (Kodiak Community Health Center Pharmacy)
• Kodiak Island Medical Associates LLC
• Kodiak Island Medical Associates LLC
• Kodiak Life Diagnostic Imaging, Inc
• Kodiak Vision Clinic & Sally's Eyeland, Inc.
• Alicia Kostelecky
• Ashley Krimmel, RN, BSN
• Janna Lacroix
• Julia Lancaster
• Kristin Elaine Langdon, HEALTH SERV TECH

• Family Medicine Physician in Kodiak, AK
• Providers in Kodiak, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2018; 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.