Individual provider Active NPI

James Michael Koch, M.D.

  • Cardiovascular Disease Physician
  • Shaker Heights, OH
National Provider Identifier
1689649337
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
35054940 Issued in OH
Practice address
20776 Brantley Rd
Shaker Heights, OH 44122-1930
Phone
(216) 296-2108
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35054940 OH Primary

Addresses

Primary practice location

20776 Brantley Rd
Shaker Heights, OH 44122-1930

Mailing address

20776 Brantley Rd
Shaker Heights, OH 44122-1930
Phone (216) 296-2108

Other identifiers 1

IdentifierTypeStateIssuer
0889150MedicaidOH

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
I20070416000006 OH Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4284526633 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of Cincinnati College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35054940OHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Apr 8, 2020 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Ashtabula County Medical Center CurrentSince Oct 9, 2021 Accepting new patients
North Ohio Heart Center Inc Cardiovascular Disease Past Accepting new patients

Locations

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

18901 Lake Shore Blvd
Euclid, OH 44119
Phone (216) 531-9000

6780 Mayfield Rd
Mayfield Hts, OH 44124
Phone (440) 331-9520

Interoperability endpoints

  • Direct secure messaging: jkoch254966@direct.ccf.org

Organizations & group practices 4

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 4

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1689649337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20776 BRANTLEY RD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441221930",
            "telephone_number": "216-296-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20776 BRANTLEY RD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441221930",
            "telephone_number": "216-296-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35054940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0889150",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaker Heights, OH

Sources for this page

Verify at the official NPI Registry.