Individual provider Active NPI

Tiffany Truong Koch, D.P.M.

  • Podiatrist
  • Indianapolis, IN
National Provider Identifier
1972923225
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
07001245A Issued in IN
Practice address
7330 E 82ND St
Suite a
Indianapolis, IN 46256-1465
Phone
(317) 712-3708
Fax
(317) 712-3798
NPI assigned
Apr 24, 2014
Last updated
Dec 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Podiatrist 213E00000X 07001245A IN Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 07001245A IN

Addresses

Primary practice location

7330 E 82ND St
Suite a
Indianapolis, IN 46256-1465

Mailing address

PO Box 330
Fortville, IN 46040-0330
Phone (317) 863-2556

Other practice location 1

10122 E 10th St Ste 230
Indianapolis, IN 46229-2664
Phone (317) 355-7356

Other identifiers 1

IdentifierTypeStateIssuer
300005049MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170605001477 IN Practitioner - Podiatry 6901118017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

10122 E 10TH St
Suite 100
Indianapolis, IN 46229-2697
Phone (317) 355-5717

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue430
Removal of skin lesions1-10
Removal of nail tissue463
Removal or shaving of skin growth96

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07001245AINMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Jul 25, 2017 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jul 25, 2017 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1221 Medical Arts Blvd
Anderson, IN 46011
Phone 76529851173453

1622 N Madison Ave
Anderson, IN 46011
Phone (765) 641-0001

10122 E 10th St
Ste 100
Indianapolis, IN 46229
Phone (317) 355-5717

10122 E 10th St
Ste 230
Indianapolis, IN 46229
Phone (317) 355-7356

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

7330 E 82nd St
Ste A
Indianapolis, IN 46256
Phone (317) 712-3708

Interoperability endpoints

  • Direct secure messaging: tkoch123008@ecommunitydirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1972923225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 330",
            "city": "FORTVILLE",
            "state": "IN",
            "postal_code": "460400330",
            "telephone_number": "317-863-2556",
            "fax_number": "317-203-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 E 82ND ST",
            "address_2": "SUITE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561465",
            "telephone_number": "317-712-3708",
            "fax_number": "317-712-3798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10122 E 10th St Ste 230",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462292664",
            "country_code": "US",
            "telephone_number": "317-355-7356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCH",
        "first_name": "TIFFANY",
        "middle_name": "TRUONG",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-24",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07001245A",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "07001245A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300005049",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.