KAREN SUE KOCH DO
NPI 1457359549
Family Medicine in Helena, MT

Active since July 12, 2005PECOS EnrolledAccepts Medicare Assignment
47.86/100
CMS Quality Rating
1645 VANDELAY AVE STE 301, HELENA, MT 59601(406) 731-8888(406) 731-8318 Get Directions Write a Review

NPPES record last updated: September 17, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Karen Sue Koch Do NPPES

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

KAREN SUE KOCH DO (NPI 1457359549) is an individual family medicine provider in Helena, Montana, licensed in Montana (144976) and active in the NPI registry since July 2005. She is enrolled in Medicare PECOS, is affiliated with St Peters Health, and maintains a secondary practice location in Akron.

NPPES Registry Identity

NPI1457359549
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameKAREN SUE KOCHCredential: DO
Location Address1645 VANDELAY AVE STE 301Helena, MT 59601-3929
Mailing AddressPo Box 6010Great Falls, MT 59406-6010 · (406) 731-8888 · Fax (406) 731-8318
Fax(406) 731-8318
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateJuly 12, 2005
Last NPPES UpdateSeptember 17, 2024
NPPES CertifiedSeptember 17, 2024
NPI 1457359549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses Licensed in MT · 144976 Licensed in IN · 02002663A
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1645 VANDELAY AVE STE 301, Helena, MT 59601

Secondary Practice Location 1

Location 1105 State Road 14 NAkron, IN 46910-0219 · Phone (574) 598-2020 · Fax (574) 223-5847

Other Identifiers 1

Medicaid200453670IN

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Karen Sue Koch Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID547297491
PECOS Enrollment IDI20240924004320
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
19 services19 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
14 services14 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Peters Health

Acute Care Hospitals · Helena, MT
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number270003
Location2475 BroadwayHelena, MT 59601 · Lewis And Clark County
Emergency services Birthing friendly

Benefis Hospitals Inc

Acute Care Hospitals · Great Falls, MT
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number270012
Location1101 26th St SGreat Falls, MT 59405 · Cascade County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 59601 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.97 typical visit price
range $56.81 – $172.26
Typical copayment $21.99 (range $14.20 – $43.06)
Most-billed visit code 99203
Established Patient
$100.16 typical visit price
range $18.24 – $140.32
Typical copayment $25.04 (range $4.56 – $35.08)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

47.86/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.13
Promoting Interoperability0
Improvement Activities40
Cost36.4

Referred Medical Equipment & Supplies CMS DME claims 14

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
10 suppliers53 claims105 services$5.40 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers24 claims24 services$1.04 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
5 suppliers20 claims20 services$45.07 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
3 suppliers18 claims79 services$23.57 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
5 suppliers15 claims15 services$70.73 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
5 suppliers11 claims11 services$24.13 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 12

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

Family Medicine
1645 VANDELAY AVE STE 301
HELENA, MT 59601
Physical Medicine & Rehabilitation (Pain Medicine)
1645 VANDELAY AVE STE 301
HELENA, MT 59601
Physician Assistant
1645 VANDELAY AVE STE 301
HELENA, MT 59601
Family Medicine
1645 VANDELAY AVE STE 301
HELENA, MT 59601
Nurse Practitioner (Family)
1645 VANDELAY AVE STE 301
HELENA, MT 59601
Physician Assistant
1645 VANDELAY AVE STE 301
HELENA, MT 59601
Internal Medicine
1645 VANDELAY AVE STE 301
HELENA, MT 59601
Orthopaedic Surgery
1645 VANDELAY AVE STE 301
HELENA, MT 59601

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 Karen Koch's NPI number?

The NPI number for Karen Koch is 1457359549. It was assigned to this individual provider in the NPPES registry on July 12, 2005.

Where is Karen Koch located?

Karen Koch practices at 1645 Vandelay Ave Ste 301, Helena, MT 59601. The listed phone number is (406) 731-8888.

What is Karen Koch's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Karen Koch enrolled in Medicare?

Yes. Karen Koch is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Karen Koch accept?

Health plans from Blue Cross and Blue Shield of Montana, CareSource, Mountain Health CO-OP and Providence Health Plan list Karen Koch as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Karen Koch affiliated with any hospitals?

According to CMS data, Karen Koch is affiliated with St Peters Health and Benefis Hospitals Inc.

When was this NPI record last updated?

The NPPES record for Karen Koch was last updated on September 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.