CAMILLE MARIE KOCH (DPT) – Geriatric Physical Therapist, NPI 1104485853
Geriatric Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,990 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WI
Provider Addresses for CAMILLE MARIE KOCH (DPT)
6600 River Pkwy
Wauwatosa, WI 532133292
Phone: (414) 476-8787
Type: Location
4885, Magnolia Lane North, Plymouth, Hennepin County, Minnesota, 55442, United States
PLYMOUTH, MN 554422078
Phone: (612) 816-0366
Type: Mailing
Prairie Ridge Boulevard, Pleasant Prairie, Kenosha County, Wisconsin, 53142, United States
PLEASANT PRAIRIE, WI 531581948
Phone: (262) 333-8158
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2019-07-17
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190717000820 | I | Physical Therapist In Private Practice | WI | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 3,005 | 60 | $0 |
| 97530 | Therapy procedure using functional activities | 2,324 | 68 | $0 |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 486 | 43 | $0 |
| 97116 | Therapy procedure for walking training, each 15 minutes | 242 | 32 | $0 |
| 97162 | Evaluation for physical therapy, typically 30 minutes | 53 | 48 | $0 |
Insurance plans in this area (ZIP 53213)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Qualified Speech Language Pathologist | IL | |
| Physical Therapist In Private Practice | IL | |
| Occupational Therapist In Private Practice | IL | |
| - | WI | |
| Physical Therapist In Private Practice | GA | |
| - | WI | |
| - | WI | |
| - | WI | |
| Physical Therapist In Private Practice | IL | |
| - | IL |
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