Individual provider Active NPI

Amber Michelle Koch, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Saint Paul, MN
National Provider Identifier
1699497750
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
528424 Issued in MN
Practice address
1216 Selby Ave
Saint Paul, MN 55104-7516
Phone
(651) 698-1729
NPI assigned
Sep 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 528424 MN Primary

Addresses

Primary practice location

1216 Selby Ave
Saint Paul, MN 55104-7516

Mailing address

1216 Selby Ave
Saint Paul, MN 55104-7516
Phone (651) 698-1729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
528424MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Therapy Spot, LLC Speech-Language Pathologist CurrentSince Sep 20, 2022 Accepting new patients
Fairview Express Care CurrentSince Jul 14, 2023 Accepting new patients
Fairview Express Care CurrentSince Jul 14, 2023 Accepting new patients
Healtheast Outpatient Services, LLC Speech-Language Pathologist CurrentSince Jul 14, 2023 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

3305 Central Park Village Dr
Ste 130
Eagan, MN 55121
Phone (651) 406-8701

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

3305 Central Park Village Dr
#130
Saint Paul, MN 55121

1216 Selby Ave
Saint Paul, MN 55104
Phone (651) 698-1729

1390 University Ave W
Saint Paul, MN 55104
Phone (651) 232-4800

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1699497750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 SELBY AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551047516",
            "telephone_number": "651-698-1729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 SELBY AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551047516",
            "telephone_number": "651-698-1729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "AMBER",
        "middle_name": "MICHELLE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "528424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.