ELIZABETH KOCH FNP
NPI 1619868122
Nurse Practitioner in Shelby Township, MI

Q: What is Elizabeth Koch's NPI number?

The NPI number for Elizabeth Koch is 1619868122. It was assigned to this individual provider in the NPPES registry on July 12, 2025.

Q: What is Elizabeth Koch's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Elizabeth Koch was last updated on August 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since July 12, 2025PECOS EnrolledAccepts Medicare Assignment

50505 SCHOENHERR RD STE 340, SHELBY TOWNSHIP, MI 48315(586) 731-8400(586) 731-8406 Get Directions Write a Review

NPPES record last updated: August 18, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 18, 2026, Jul 12, 2025 (2 updates tracked since 2025).

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About Elizabeth Koch Fnp NPPES

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

ELIZABETH KOCH FNP (NPI 1619868122) is an individual nurse practitioner in Shelby Township, Michigan, licensed in Michigan (4704360838) and active in the NPI registry since July 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1619868122

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameELIZABETH KOCHCredential: FNP

Location Address50505 SCHOENHERR RD STE 340Shelby Township, MI 48315-3140

Mailing Address50505 Schoenherr Rd Ste 340Shelby Township, MI 48315-3140 · (586) 731-8400 · Fax (586) 731-8406

Phone(586) 731-8400

Fax(586) 731-8406

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateJuly 12, 2025

Last NPPES UpdateAugust 18, 20262 updates tracked since enumeration

NPPES CertifiedAugust 18, 2026

✔ NPI 1619868122 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in MI · 4704360838

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedHospitalistTaxonomy 208M00000X · License 4704360838 (MI)

50505 SCHOENHERR RD STE 340, Shelby Township, MI 48315

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Elizabeth Koch Fnp 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 ID6305318171

PECOS Enrollment IDI20260611004785

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.

Medicare Billing Reassignment

Medicare enrollment records show Elizabeth Koch reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Great Lakes Medicine, Plc

Same address

Hospitalist

50505 SCHOENHERR RD, STE 340
Shelby Township, MI 48315

Reassigned Medicare billing, Michigan enrollment
51 clinicians in this Medicare group

NPI 1740210517 (586) 731-8400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48315 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

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

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.

Other Providers at the Same Location NPPES 20

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

DR. MALAZ ALATASSI M.D.

Internal Medicine