SEBASTIAN KOCH MD
NPI 1831155779
Psychiatry & Neurology - Neurology in Miami, FL

Q: What is Sebastian Koch's NPI number?

The NPI number for Sebastian Koch is 1831155779. It was assigned to this individual provider in the NPPES registry on April 20, 2006.

Q: What is Sebastian Koch's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Q: When was this NPI record last updated?

The NPPES record for Sebastian Koch was last updated on February 20, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.

Active since April 20, 2006PECOS EnrolledAccepts Medicare Assignment

81.31/100

CMS Quality Rating

1475 NW 12TH AVE, BOX 016960 M851, MIAMI, FL 33136(305) 243-7520(305) 243-8470 Get Directions Write a Review

NPPES record last updated: February 20, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Sebastian Koch Md NPPES

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

SEBASTIAN KOCH MD (NPI 1831155779) is an individual neurology provider in Miami, Florida, licensed in Florida (ME70460) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Jackson Health System, and is a graduate of Wake Forest University School Of Medicine (1993).

NPPES Registry Identity

NPI1831155779

Entity TypeIndividualMale

Primary Taxonomy2084N0400X

Provider Legal NameSEBASTIAN KOCHCredential: MD

Location Address1475 NW 12TH AVE, BOX 016960 M851Miami, FL 33136-1002

Mailing Address1475 Nw 12th Ave, Box 016960 M851Miami, FL 33136-1002 · (305) 243-7520 · Fax (305) 243-8470

Phone(305) 243-7520

Fax(305) 243-8470

Sole ProprietorNo

Medical School CMSWake Forest University School Of MedicineGraduated 1993

Enumeration DateApril 20, 2006

Last NPPES UpdateFebruary 20, 2013

✔ NPI 1831155779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians

Taxonomy Code2084N0400X

License✔ Licensed in FL · ME70460

Definition

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

1475 NW 12TH AVE, Miami, FL 33136

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Other Identifiers 3

Medicaid257431400FL

Medicare UPING90815FL

Medicare UPIN46352FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, AmeriHealth Caritas Next and more.Insurance ›

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

Sebastian Koch Md 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 ID2163546656

PECOS Enrollment IDI20100907000438

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

University Of Miami

Same address

Radiation Oncology

1475 NW 12TH AVE, BOX 016960 M851
Miami, FL 33136

Reassigned Medicare billing, Florida enrollment
3,639 clinicians in this Medicare group

NPI 1689624108 (305) 243-7688

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

Areas of Expertise CMS Part B claims 13

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 low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

93 services80 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

78 services65 patients

Ultrasound of both sides of head and neck blood flow 93880

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

41 services39 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

41 services27 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

29 services19 patients

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.

26 services25 patients

Complete ultrasound of within the brain blood flow 93886

A complete ultrasound of brain blood flow, also known as a Transcranial Doppler, is a non-invasive procedure that uses sound waves to measure the speed and direction of blood flow in the brain. This helps detect any abnormalities or blockages.

21 services21 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

19 services19 patients

Complete ultrasound of within the brain blood flow 93886

17 services17 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

16 services16 patients

Ultrasound of within the brain blood flow for blood clots 93892

An ultrasound of the brain's blood flow is a safe, non-invasive procedure that uses sound waves to create images of the blood vessels. This helps identify any blockages, like blood clots, that might disrupt normal blood flow and cause health issues.

12 services11 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.

12 services12 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

12 services11 patients

Hospital Affiliations CMS Care Compare

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

Jackson Health System

Acute Care Hospitals · Miami, FL

1/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100022

Location1611 NW 12th AveMiami, FL 33136 · Miami-Dade County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33136 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

$141.56 typical visit price

range $60.92 – $187.05

Typical copayment $35.39 (range $15.23 – $46.76)

Most-billed visit code 99204

Established Patient

$107.17 typical visit price

range $18.99 – $150.24

Typical copayment $26.79 (range $4.74 – $37.56)

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.

81.31/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

78.45

Promoting Interoperability

100

Improvement Activities

Cost

50.59

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.

MS. ALISSETTE NAVEDA ARNP

Nurse Practitioner (Family)

1475 NW 12TH AVE
MIAMI, FL 33136

Miami-Dade County (305) 243-5360

WALTER G BRADLEY

Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)

1475 NW 12TH AVE, BOX 016960 M851
MIAMI, FL 33136

Miami-Dade County (305) 243-7520

DR. EVAN H SCHLAM MD

Dermatology

1475 NW 12TH AVE, BOX 016960
MIAMI, FL 33136

Miami-Dade County (305) 243-7688

DR. NESTOR RICARDO VILLAMIZAR M.D.

Thoracic Surgery (Cardiothoracic Vascular Surgery)

1475 NW 12TH AVE
MIAMI, FL 33136

Miami-Dade County (305) 243-2363

MS. LINDSAY MARIE THORNTON MD

Radiology (Vascular & Interventional Radiology)

1475 NW 12TH AVE
MIAMI, FL 33136

Miami-Dade County (305) 243-5512

DR. GLENDA C HARRIS PH.D., L.AC.

Acupuncturist

1475 NW 12TH AVE
MIAMI, FL 33136

Miami-Dade County (305) 243-1470

IVAYLO MIHAYLOV

Radiology (Radiation Oncology)

1475 NW 12TH AVE, SUITE 1500
MIAMI, FL 33136

Miami-Dade County (305) 243-8223

LOURDES MESTRE VALDES APRN

Nurse Practitioner (Gerontology)

1475 NW 12TH AVE
MIAMI, FL 33136

Miami-Dade County (305) 243-4902

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 Sebastian Koch's NPI number?

The NPI number for Sebastian Koch is 1831155779. It was assigned to this individual provider in the NPPES registry on April 20, 2006.

Where is Sebastian Koch located?

Sebastian Koch practices at 1475 NW 12th Ave Box 016960 M851, Miami, FL 33136. The listed phone number is (305) 243-7520.

What is Sebastian Koch's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Sebastian Koch enrolled in Medicare?

Yes. Sebastian 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.

Which organization bills Medicare for Sebastian Koch's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sebastian Koch reassigns Medicare benefits to University Of Miami (Miami, FL). 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 Sebastian Koch's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sebastian Koch accept?

Health plans from Ambetter Health, Ambetter of Alabama, AmeriHealth Caritas Next, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 3 other insurers list Sebastian 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 Sebastian Koch affiliated with any hospitals?

According to CMS data, Sebastian Koch is affiliated with Jackson Health System.

When was this NPI record last updated?

The NPPES record for Sebastian Koch was last updated on February 20, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.