Gary Koch, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PS018065 Issued in PA

Practice address

500 Market St Ste 204B
Beaver, PA 15009

Phone

(724) 728-6670

Fax

(724) 728-5570

NPI assigned

Jul 21, 2016

Last updated

Jul 21, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Psychology & Learning Center Inc

  dba Psychology and Learning Center

  • Clinic/Center
  • Monaca, PA
  • NPI 1710771670
  Medicare reassignment NPD
• Psychology and Learning Center - Butler PC

  • Psychologist
  • Butler, PA
  • NPI 1932068558
  Medicare reassignment NPD
• Psychology and Learning Center

  • Clinical Child & Adolescent Psychologist
  • Monaca, PA
  • NPI 1104993864
  Authorized official Same address or phone
• Psychology and Learning Center, Inc

  • Clinical Psychologist
  • Monaca, PA
  • NPI 1568618114
  NPD (past) Authorized official

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532131200000",
    "number": "1861845208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MARKET ST STE 204B",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150092998",
            "telephone_number": "724-728-6670",
            "fax_number": "724-728-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARKET ST STE 204B",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "15009",
            "telephone_number": "724-728-6670",
            "fax_number": "724-728-5570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Serendipity Dr",
            "address_purpose": "LOCATION",
            "city": "Coraopolis",
            "state": "PA",
            "postal_code": "151081153",
            "country_code": "US",
            "telephone_number": "412-980-6532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCH",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-21",
        "last_updated": "2018-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PA",
            "license": "PS018065",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "PA",
            "license": "PS018065",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1032369400002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert C Knapp, M.D.
• Thomas Knapp
• Knapps Limited
• Madison Suzanne Foster Knepper, PA-C
• Brandin Knight, DPT
• Jennifer Lea Kos, PSYD
• Kathryn E Kraus, MD
• Desiree Kretchmar, RD, LDN
• Kroner and Associates Counseling (Mike Kroner Counseling)
• Michael R Kroner Jr.

• Clinical Child & Adolescent Psychologist in Beaver, PA
• Providers in Beaver, PA by specialty
• Clinical Child & Adolescent Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.