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DR. PAUL ERWIN KOCH O.D.
NPI 1124060041
Optometrist in Ponderay, ID

Active since June 12, 2006Opted out of Medicare · through Jul 1, 2028
476999 HIGHWAY 95, PONDERAY, ID 83852(208) 255-5513(208) 255-5823 Get Directions Write a Review

NPPES record last updated: April 14, 2009. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Dr. Paul Erwin Koch O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PAUL ERWIN KOCH O.D. (NPI 1124060041) is an individual optometrist in Ponderay, Idaho, licensed in Idaho (ODP-1026) and active in the NPI registry since June 2006. He has opted out of Medicare through July 1, 2028.

NPPES Registry Identity

NPI1124060041
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. PAUL ERWIN KOCHCredential: O.D.
Location Address476999 HIGHWAY 95Ponderay, ID 83852-9738
Mailing Address1455 Janish DrSandpoint, ID 83864-6244 · (208) 255-4801 · Fax (208) 255-5823
Phone(208) 255-5513
Fax(208) 255-5823
Sole ProprietorNo
Enumeration DateJune 12, 2006
Last NPPES UpdateApril 14, 2009
✔ NPI 1124060041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in ID · ODP-1026
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
476999 HIGHWAY 95, Ponderay, ID 83852
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Other Identifiers 3

Medicaid806343800ID
Medicare ID-Type Unspecified1593991ID
Medicare UPINT48172ID

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Paul Erwin Koch O.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2022 through July 1, 2028.

Opt-Out Effective DateJuly 1, 2022
Opt-Out In Effect ThroughJuly 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%28 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WAL-MART STORES, INC
Eyewear Supplier
476999 HIGHWAY 95
PONDERAY, ID 83852
Bonner County (208) 265-8332
DR. PAUL E. KOCH, OPTOMETRIST, P.C
Optometrist
476999 HIGHWAY 95, C/O WALMART VISION CENTER
PONDERAY, ID 83852
Bonner County (208) 255-5513
WALMART INC.
Pharmacy (Community/Retail Pharmacy)
476999 HIGHWAY 95
PONDERAY, ID 83852
Bonner County (208) 265-4490
AMY MCGRATH PHARMACIST
Pharmacist
476999 HIGHWAY 95
PONDERAY, ID 83852
Bonner County (208) 265-4490

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Paul Koch's NPI number?

The NPI number for Paul Koch is 1124060041. It was assigned to this individual provider in the NPPES registry on June 12, 2006.

Where is Paul Koch located?

Paul Koch practices at 476999 Highway 95, Ponderay, ID 83852. The listed phone number is (208) 255-5513.

What is Paul Koch's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Paul Koch enrolled in Medicare?

No. Paul Koch has opted out of Medicare through July 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Paul Koch was last updated on April 14, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.