Jason R Koch, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1144 Issued in SD

Practice address

7220 Mount Rushmore Rd
Rapid City, SD 57702

Phone

(605) 341-1414

Fax

(605) 341-7062

NPI assigned

Oct 3, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Black Hills Surgical Hospital LLCGroup PAC ID 5496742835, 173 clinicians

Black Hills Orthopedic and Spine Center IncGroup PAC ID 0648172932, 73 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Black Hills Surgical Hospital LLC Hospital, Rapid City, SD, CCN 430091
• Monument Health Spearfish Hospital Hospital, Spearfish, SD, CCN 430048

Merit-based Incentive Payment System (MIPS)

Final score

95.06 of 100Reported as group

Quality

99.26

Promoting interoperability

90

Improvement activities

40

Cost

92.59

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Black Hills Orthopedic & Spine Center, Inc.

  • Multi-Specialty Clinic/Center
  • Rapid City, SD
  • NPI 1477523678
  Medicare reassignment Care Compare group
• Black Hills Surgical Hospital, LLC

  • Urgent Care Clinic/Center
  • Rapid City, SD
  • NPI 1336009646
  Medicare reassignment Care Compare group

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

• Black Hills Surgical Hospital, LLC

  • Special Hospital
  • Rapid City, SD
  • NPI 1679535132
  Care Compare affiliation
• Monument Health Network, Inc.

  • General Acute Care Hospital
  • Spearfish, SD
  • NPI 1033183942
  Care Compare affiliation
• Monument Health Network, Inc.

  • Dermatology Physician
  • Spearfish, SD
  • NPI 1477932390

  Hospital

  Care Compare affiliation
• Monument Health Network, Inc.

  • General Acute Care Hospital
  • Spearfish, SD
  • NPI 1548648264
  Care Compare affiliation
• Monument Health Network, Inc.

  • General Acute Care Hospital
  • Spearfish, SD
  • NPI 1720491137
  Care Compare affiliation
• Monument Health Network, Inc.

  • Orthopaedic Surgery Physician
  • Spearfish, SD
  • NPI 1811375496

  Hospital

  Care Compare affiliation
• Monument Health Network, Inc.

  • Multi-Specialty Clinic/Center
  • Spearfish, SD
  • NPI 1902284581

  Hospital

  Care Compare affiliation
• Monument Health Network, Inc.

  • Rehabilitation Hospital Unit
  • Belle Fourche, SD
  • NPI 1972779957
  Care Compare affiliation

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

{
    "created_epoch": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1922401066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7220 MOUNT RUSHMORE RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028754",
            "telephone_number": "605-737-9144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7220 MOUNT RUSHMORE RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57702",
            "telephone_number": "605-341-1414",
            "fax_number": "605-341-7062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2929 5th St",
            "address_2": "Suite 240",
            "address_purpose": "LOCATION",
            "city": "Rapid City",
            "state": "SD",
            "postal_code": "577017363",
            "country_code": "US",
            "telephone_number": "605-755-4150",
            "fax_number": "605-755-4152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCH",
        "first_name": "JASON",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-03",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "1144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Siri Shirene Knutsen Larson, M.D.
• Roger Steven Knutsen, M.D.
• Kaleh June Knutson, FNP
• Mary Beth Kobza Halle, MA
• Koch Medicine LLC
• Sherri Danelle Koch, MD
• Vicki Colleen Koebernick, D.C.
• Michael Andrew Koehn, D.C.
• Amanda Koepp
• Emma Koetter

• Physician Assistant in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Physician Assistant in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.