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BOMI KOCH
NPI 1750540605
Pediatrics in Roseville, CA

Active since June 05, 2008PECOS Enrolled
3100 DOUGLAS BLVD, ROSEVILLE, CA 95661(916) 774-8500(916) 781-3422 Get Directions Write a Review

NPPES record last updated: February 4, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Bomi Koch NPPES

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

BOMI KOCH (NPI 1750540605) is an individual pediatrics provider in Roseville, California, licensed in California (A106739) and active in the NPI registry since June 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1750540605
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameBOMI KOCH
Location Address3100 DOUGLAS BLVDRoseville, CA 95661-3866
Mailing Address10470 Old Placerville RdSacramento, CA 95827-2539 · (800) 470-0071
Phone(916) 774-8500
Fax(916) 781-3422
Sole ProprietorNo
Enumeration DateJune 5, 2008
Last NPPES UpdateFebruary 4, 2019
✔ NPI 1750540605 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A106739
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
3100 DOUGLAS BLVD, Roseville, CA 95661
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Other Names 1

Former Name (1)Kww Bum Chang

Other Identifiers 1

OtherA106739CA · State License

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bomi Koch is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Bomi Koch reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sutter Medical Foundation
13 mi
Diagnostic Radiology
2800 L ST FL 7
Sacramento, CA 95816
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Sutter Valley Medical Foundation
  • 3,056 clinicians in this Medicare group
NPI 1942524095 (916) 731-7857

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 95661 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
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
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.

JENINA SEGALE RD
Dietitian, Registered
3100 DOUGLAS BLVD
ROSEVILLE, CA 95661
Placer County (916) 774-8885
ANN MARIE WINTERTON LCSW
Dietitian, Registered
3100 DOUGLAS BLVD, SUITE 204
ROSEVILLE, CA 95661
Placer County (916) 774-8885
MARIA-DOLORES CERQUEIRA HANEFFANT PA
Physician Assistant (Medical)
3100 DOUGLAS BLVD
ROSEVILLE, CA 95661
Placer County (916) 774-8300
RUPINDER TUMBER RD
Dietitian, Registered
3100 DOUGLAS BLVD
ROSEVILLE, CA 95661
Placer County (916) 774-8885
MRS. GINA M WHITELEY I RD, CDE
Dietitian, Registered
3100 DOUGLAS BLVD
ROSEVILLE, CA 95661
Placer County (916) 865-1140
DR. KENNY BAINS M.D.
Family Medicine
3100 DOUGLAS BLVD
ROSEVILLE, CA 95661
Placer County (916) 774-8300
PATRICIA MARIE DIXSON FNP
Nurse Practitioner (Family)
3100 DOUGLAS BLVD, SUITE 325
ROSEVILLE, CA 95661
Placer County (916) 241-9844
DR. ROGER ANG M.D.
Family Medicine
3100 DOUGLAS BLVD
ROSEVILLE, CA 95661
Placer County (916) 774-8300

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 Bomi Koch's NPI number?

The NPI number for Bomi Koch is 1750540605. It was assigned to this individual provider in the NPPES registry on June 5, 2008. The provider is also known as Kww Bum Chang.

Where is Bomi Koch located?

Bomi Koch practices at 3100 Douglas Blvd, Roseville, CA 95661. The listed phone number is (916) 774-8500.

What is Bomi Koch's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Bomi Koch enrolled in Medicare?

Yes. Bomi Koch is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Bomi Koch's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Bomi Koch reassigns Medicare benefits to Sutter Medical Foundation (Sacramento, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Bomi Koch's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Bomi Koch was last updated on February 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.