DR. ANDREW JAMES KOON M.D. NPI 1457326639
Internal Medicine in Carmel, IN

About DR. ANDREW JAMES KOON M.D.

Andrew Koon is an internist established in Carmel, Indiana and his medical specialization is Internal Medicine with more than 24 years of experience. He graduated from University Of South Florida College Of Medicine in 1999. The NPI number of Andrew Koon is 1457326639 and was assigned on February 2006. The practitioner's primary taxonomy code is 207R00000X with license number 01059733A (IN). The provider is registered as an individual and his NPI record was last updated 12 years ago.

NPI
1457326639
Provider NameDR. ANDREW JAMES KOON M.D.
Location Address13500 N MERIDIAN ST CARMEL, IN 46032
Location Phone(317) 582-7000
Mailing Address13500 N MERIDIAN ST CARMEL, IN 46032
GenderMale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY OF SOUTH FLORIDA COLLEGE OF MEDICINE
Graduation Year1999
Is Sole Proprietor?No
Enumeration Date02-21-2006
Last Update Date08-24-2010

An internist like Dr. Andrew James Koon M.d. is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.Andrew Koon is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Andrew Koon is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Riverview Health.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 96.7, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.7 for a new patient copayment and $24.53 for an established patient copayment.



Primary Taxonomy

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Taxonomy Code207R00000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
License No.01059733A
License StateIN
Taxonomy DescriptionA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Business Address

DR. ANDREW JAMES KOON M.D.
13500 N MERIDIAN ST
CARMEL, IN
ZIP 46032
Phone: (317) 582-7000

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Mailing Address

DR. ANDREW JAMES KOON M.D.
13500 N MERIDIAN ST
CARMEL, IN
ZIP 46032
Phone: (317) 582-7000


Location Map

PECOS Enrollment and Medicare Participation Status

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID9436200482
PECOS Enrollment IDI20090702000192
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 46032 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$54.76 $167.54 $126.81
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$13.69 $41.88 $31.7
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$16.96 $137.16 $98.12
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.24 $34.29 $24.53

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

MIPS Measure Score Weight Score
Quality 40% 100
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability (PI) 25% 80.4
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities 15% 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost 20% N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
MIPS Final Score - 96.7
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Andrew Koon is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
RIVERVIEW HEALTH395 WESTFIELD RD
NOBLESVILLE, IN 46060
(317) 773-0760Acute Care Hospitals150059

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineME81976FLNo

Taxonomy Description: a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1457326639
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
24107621266
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 1 + 0 + 7 + 6 + 2 + 1 + 2 + 6 + 6 + 24 = 61
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 61 = 99

The NPI number 1457326639 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 10 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1902830094MRS. KAREN S WALL PHARMD
Individual
Pharmacist13500 N MERIDIAN ST
CARMEL, IN 46032
(317) 582-8096
1447391586DR. RUDOLPH V FOY MD
Individual
General Acute Care Hospital13500 N MERIDIAN ST
CARMEL, IN 46032
(317) 582-7678
1831158807MID AMERICA CLINICAL LABORATORIES, LLC
Organization
Clinical Medical Laboratory13500 N MERIDIAN ST
CARMEL, IN 46032
(317) 803-0707
1619511201 SHELBY NICOLE DUNCAN RD, LD
Individual
Dietitian, Registered13500 N MERIDIAN ST
CARMEL, IN 46032
(317) 582-8458
1962802660 STEVEN PETER CHOU
Individual
Internal Medicine13500 N MERIDIAN ST
CARMEL, IN 46032
(317) 582-7000
1639124134ST. VINCENT CARMEL HOSPITAL, INC.
Organization
General Acute Care Hospital13500 N MERIDIAN ST
CARMEL, IN 46032
(317) 582-7380
1154913465 JOY DAWN ISNER RUGENSTEIN NP
Individual
Nurse Practitioner (Primary Care)13500 N MERIDIAN ST
CARMEL, IN 46032
(317) 582-7000
1275987737 SEAN TOKITA D.O.
Individual
Emergency Medicine13500 N MERIDIAN ST
CARMEL, IN 46032
(626) 354-3195
1053973727MISS LAUREN CHRISTINE TANDARICH PA-C
Individual
Physician Assistant13500 N MERIDIAN ST
CARMEL, IN 46032
(317) 582-7000
1568934271 PAPA M DIOP AGPCNP
Individual
Nurse Practitioner (Primary Care)13500 N MERIDIAN ST
CARMEL, IN 46032
(317) 582-7000

Frequently Asked Questions

What is Dr. Andrew Koon M.D. NPI number?

The NPI number assigned to Dr. Andrew Koon M.D. is 1457326639, registered as an "individual" on February 21, 2006

Where is Dr. Andrew Koon M.D. located?

The provider is located at 13500 N Meridian St Carmel, In 46032 and the phone number is (317) 582-7000

Which is Dr. Andrew Koon M.D. specialty?

The provider's speciality is Internal Medicine

How many years of experience does Dr. Andrew Koon M.D. have?

The provider has more than 24 years of experience. He graduated from University Of South Florida College Of Medicine in 1999.

Is Dr. Andrew Koon M.D. registered in PECOS?

Yes, as of November 14, 2022 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

How much is a visit to Dr. Andrew Koon M.D.?

Medicare beneficiaries should expect a typical cost of $126.81 with an average copayment of $31.7 for new patient appointments. Established patients should expect a typical charge of $98.12 and an average copayment of 24.53. Please review your insurance plan or contact the provider directly to determine your specific costs.

Is Dr. Andrew Koon M.D. affiliated to any hospitals?

The practitioner is affiliated to the following hospitals: RIVERVIEW HEALTH. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

How do I update my NPI information?

The NPI record of Dr. Andrew Koon M.D. was last updated on February 21, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]