NPIMap

Individual provider Active NPI

Lisa Kristine Koch, MD PHD

  • Anatomic Pathology Physician
  • Bellingham, WA
National Provider Identifier
1639468762
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
MD60533531 Issued in WA
Practice address
3614 Meridian St Ste 100
Bellingham, WA 98225-1748
Phone
(360) 734-2800
Fax
(360) 734-3818
NPI assigned
Mar 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X MD60533531 WA Primary

Addresses

Primary practice location

3614 Meridian St Ste 100
Bellingham, WA 98225-1748

Mailing address

3560 Meridian St Ste 101
Bellingham, WA 98225-1731
Phone (360) 734-2800

Other identifiers 1

IdentifierTypeStateIssuer
1639468762MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150616000345 WA Practitioner - Pathology 3971814146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Pathology PLLCGroup PAC ID 4587553318, 7 clinicians

Practice addresses (Care Compare)

3560 Meridian St
Suite 101
Bellingham, WA 98225-1731
Phone (360) 734-2800

3614 Meridian St
Suite 100
Bellingham, WA 98225-1748
Phone (360) 734-2800

Hospital & facility affiliations

  • Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003
  • Jefferson Healthcare Hospital, Port Townsend, WA, CCN 501323
  • Peacehealth St Joseph Medical Center Hospital, Bellingham, WA, CCN 500030
  • Astria Toppenish Hospital Hospital, Toppenish, WA, CCN 500037
  • Summit Pacific Medical Center Hospital, Elma, WA, CCN 501304

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Pathology PLLC PastSince Nov 1, 2020 Accepting new patients

Organizations & group practices 2

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 9

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": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1639468762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 MERIDIAN ST STE 101",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251731",
            "telephone_number": "360-734-2800",
            "fax_number": "360-734-3818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3614 MERIDIAN ST STE 100",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251748",
            "telephone_number": "360-734-2800",
            "fax_number": "360-734-3818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "LISA",
        "middle_name": "KRISTINE",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-29",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "WA",
            "license": "MD60533531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639468762",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.