Brian Koch

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

25MA10240700 Issued in NJ

Practice address

1 Bay St
Glen Ridge, NJ 07028-1505

Phone

(925) 595-1994

NPI assigned

Apr 1, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, NJ2 enrollments

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 2

Specialty

Emergency Medicine

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Montclair Emergency Physicians LLCGroup PAC ID 2264841857, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hackensack Meridian Mountainside Medical Hospital, Montclair, NJ, CCN 310054

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bkoch188963@ahs.direct-ci.com

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.

• Montclair Emergency Physicians LLC

  • Emergency Medicine Physician
  • Montclair, NJ
  • NPI 1851979470

  Emergency Medicine, NJ

  Medicare reassignment Care Compare group NPD
• Emergency Associates of Montclair LLC

  • Emergency Medicine Physician
  • Montclair, NJ
  • NPI 1598112146

  Emergency Medicine, NJ

  Medicare reassignment NPD
• Cep America - California

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542

  CA, Emergency Medicine

  Medicare reassignment NPD
• Cep America - California

  • Emergency Medicine Physician
  • Paradise, CA
  • NPI 1225353600

  Emergency Medicine

  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848

  Emergency Medicine

  NPD

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

• Montclair Hospital LLC

  • General Acute Care Hospital
  • Montclair, NJ
  • NPI 1982720249

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1972998417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 HUDSON ST APT 1",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305849",
            "telephone_number": "925-595-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAY ST",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281505",
            "telephone_number": "925-595-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "BRIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-01",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA10240700",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A149062",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamlesh Khanna, MD
• Martine Kieffer, LCSW
• Samuel Kim, MD
• Sung T. Kim, M.D.
• Dusan Knezevic, MD
• Randy Kolodny, PT, DPT
• Ksa Medical LLC
• Yong Min Kwon, M.D.
• Robert Labruzza, D.C.
• Jill D Langell, OTR/L

• All providers in Glen Ridge, NJ
• Emergency Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.