KEVIN G. KOTH D.O.
NPI 1972798049
Orthopaedic Surgery in Highland, IL

Q: What is Kevin Koth's NPI number?

The NPI number for Kevin Koth is 1972798049. It was assigned to this individual provider in the NPPES registry on September 11, 2007.

Q: What is Kevin Koth's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Koth was last updated on March 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 September 11, 2007PECOS EnrolledAccepts Medicare Assignment

95.01/100

CMS Quality Rating

12866 TROXLER AVE, HIGHLAND, IL 62249(618) 900-1070(833) 992-2437 Get Directions Write a Review

NPPES record last updated: March 5, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 5, 2026, Oct 13, 2021, May 26, 2021 and 4 more (7 updates tracked since 2017).

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About Kevin G. Koth D.o. NPPES

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

KEVIN G. KOTH D.O. (NPI 1972798049) is an individual orthopaedic surgery provider in Highland, Illinois, licensed in Illinois (036132543) and active in the NPI registry since September 2007. He is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital -centralia, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1972798049

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameKEVIN G. KOTHCredential: D.O.

Location Address12866 TROXLER AVEHighland, IL 62249-2806

Mailing AddressPo Box 160Troy, IL 62294-0160 · (618) 900-1070 · Fax (833) 992-2437

Phone(618) 900-1070

Fax(833) 992-2437

Sole ProprietorYes

Medical School CMSOhio University, College Of Osteopathic MedicineGraduated 2007

Enumeration DateSeptember 11, 2007

Last NPPES UpdateMarch 5, 20267 updates tracked since enumeration

NPPES CertifiedMarch 5, 2026

✔ NPI 1972798049 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

Licenses✔ Licensed in IL · 036132543✔ Licensed in IN · 02003992A✔ Licensed in KY · 03476

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Also ListedOrthopaedic Surgery · Orthopaedic Surgery of the SpineTaxonomy 207XS0117X · License 03476 (KY)

12866 TROXLER AVE, Highland, IL 62249

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Secondary Practice Locations 3

Location 1650 W Taylor StVandalia, IL 62471-1227 · Phone (618) 283-5531

Location 2400 Maple Summit RdJerseyville, IL 62052-2028 · Phone (186) 498-8472 · Fax (618) 498-8461

Location 39515 Holy Cross Ln Ste 2Breese, IL 62230-3618 · Phone (618) 900-1070

Other Identifiers 4

Medicaid201114320AIN

Medicaid036-132543IL

Other000000777934KY · Anthem

Medicaid7100213750KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.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

Kevin G. Koth D.o. 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 ID8123274917

PECOS Enrollment IDI20130813000526

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 12

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.

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

160 services103 patients

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.

159 services115 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

57 services57 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

42 services26 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.

30 services28 patients

Injection into tendon or ligament 20550

An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.

21 services16 patients

Treatment of broken neck of thigh bone with bone implant 27245

This procedure involves repairing a fractured thigh bone by inserting a bone implant. The implant helps stabilize the bone, allowing it to heal correctly. It's performed under anesthesia and requires a hospital stay for recovery.

21 services21 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

20 services20 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.

19 services19 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.

18 services18 patients

Release and/or relocation of hand nerve 64721

This procedure involves adjusting or moving a nerve in your hand to alleviate discomfort or improve function. The nerve may be compressed, causing pain or numbness. By releasing or relocating the nerve, these symptoms can be reduced, enhancing hand usage.

15 services13 patients

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

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Ssm Health St Mary's Hospital -Centralia

Acute Care Hospitals · Centralia, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140034

Location400 North Pleasant AvenueCentralia, IL 62801 · Marion County

Emergency services

Jersey Community Hospital

Acute Care Hospitals · Jerseyville, IL

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number140059

Location400 Maple Summit RoadJerseyville, IL 62052 · Jersey County

Emergency services

St Josephs Hospital

Acute Care Hospitals · Breese, IL

OwnershipVoluntary non-profit - Church

CMS Certification Number140145

Location9515 Holy Cross LnBreese, IL 62230 · Clinton County

Emergency services Birthing friendly

Hshs St Elizabeth's Hospital

Acute Care Hospitals · O Fallon, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140187

LocationOne St Elizabeth BoulevardO Fallon, IL 62269 · St. Clair County

Emergency services Birthing friendly

Salem Township Hospital

Critical Access Hospitals · Salem, IL

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number141345

Location1201 Ricker DriveSalem, IL 62881 · Marion County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62249 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

$88.44 typical visit price

range $56.28 – $173.35

Typical copayment $22.11 (range $14.07 – $43.33)

Most-billed visit code 99203

Established Patient

$70.42 typical visit price

range $17.51 – $139.99

Typical copayment $17.60 (range $4.37 – $34.99)

Most-billed visit code 99213

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.

95.01/100

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

Scored through an Alternative Payment Model

Quality

80.02

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report

30%33 patients2/55-star benchmark: 87%

Documentation of Current Medications in the Medical Record

51%242 patients2/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

0%63 patients1/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

24%144 patients1/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

0%144 patients1/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

20%128 patients2/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients screened: 2% · 138 patients

2%138 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 17

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

INFINITY-MEDS URGENT CARE SERVICES LLC

Emergency Medicine