DR. JOHANNA KOCH (M.D.) – Family Medicine Physician, NPI 1104835057

DR. JOHANNA KOCH (M.D.) is a healthcare provider. based in Incline village, Nevada. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. 5548 (NV). The NPI Number for DR. JOHANNA KOCH (M.D.) is 1104835057

Main info

Female
Sole Proprietor
42 Years Of Experience
Accepts Medicare Assignment
Name
DR. JOHANNA KOCH (M.D.)
NPI
1104835057
Phone
(775) 832-5200
Address
889 ALDER AVE. #203
Enumeration Date
7 August 2006
Last Update Date
26 January 2012

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Secondary Phone
5305876011
Graduation Year
1984 (42 years ago)
PAC ID
7517095557
Group Practice PAC ID
0446161335
Professional Enrollment ID
I20110519000210
Address ID
CA961614835TR10121AVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

992 FAMILY PRACTICE in NV

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Provider Addresses for DR. JOHANNA KOCH (M.D.)

  • Alder Avenue, Incline Village, Washoe County, Nevada, 89451, United States

    INCLINE VILLAGE, NV 89451

    Phone: (775) 832-5200

    Fax: (775) 832-5205

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $108.

Total Amount is formed as General ($108) + Research ($0) + Ownership ($0) = $108.

Last reported payment date: 2024-03-13 • Largest payer in this snapshot: Novo Nordisk Inc ($108).

Total Amount

$108

General + Research + Ownership

Payments

1

Total payment records

General Amount

$108

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-13

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Novo Nordisk Inc$108
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-05-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100512000250IFamily PracticeNVTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 89451)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0446161335View full group profile
NameSpecialtyState
Physician AssistantCA
General SurgeryCA
-CA
A N E S T H E S I O L O G YAZ
A N E S T H E S I O L O G YNV
Internal MedicineNV
Nurse PractitionerCA
Nurse PractitionerCA
Physician AssistantCA
O B S T E T R I C S/ G Y N E C O L O G YNV

Reviews

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Frequently asked questions

Does DR. JOHANNA KOCH (M.D.) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. JOHANNA KOCH (M.D.) uses 1104835057.
Is DR. JOHANNA KOCH (M.D.) listed as active for patients and plans?
The listing shows DR. JOHANNA KOCH (M.D.) as active in the NPI system.
What is DR. JOHANNA KOCH (M.D.) best known for clinically?
Directory data describes DR. JOHANNA KOCH (M.D.) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Does DR. JOHANNA KOCH (M.D.) list a practice location?
Patients near Incline Village, Nevada may find DR. JOHANNA KOCH (M.D.) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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