Austin Lee Koch (NPI# 1407293236, PAC ID# 2567606288) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1407293236 |
| PAC ID by PECOS | 2567606288 |
| Professional Enrollment ID | I20160909001626 |
| Full Name | Austin Lee Koch |
| Organization Legal Name | BLUEJACKET EMERGENCY PHYSICIANS LLC |
| Address |
13505 S Alden St Olathe KS 66062-5840 |
| Phone Number | 9135415000 |
| Gender | M |
| Medical School | UNIVERSITY OF KANSAS SCHOOL OF MEDICINE |
| Graduation Year | 2013 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 0648423632 |
| Number of Group Practice Members | 28 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 170185 | SAINT LUKE'S SOUTH HOSPITAL |
| 170176 | OVERLAND PARK REG MED CTR |
| 170146 | PROVIDENCE MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 13505 S Alden St, Olathe, KS 66062-5840 | 9135415000 | BLUEJACKET EMERGENCY PHYSICIANS LLC |
| 10310 Shawnee Mission Pkwy, Shawnee, KS 66203-3502 | 9132278400 | BLUEJACKET EMERGENCY PHYSICIANS LLC |
| Organization Legal Name | BLUEJACKET EMERGENCY PHYSICIANS LLC |
| Physicians | 21 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Justin K Cherian | Emergency Medicine | Bluejacket Emergency Physicians LLC | 10310 Shawnee Mission Pkwy, Shawnee, KS 66203-3502 |
| Andrew S Dalton | Emergency Medicine | Bluejacket Emergency Physicians LLC | 13505 S Alden St, Olathe, KS 66062-5840 |
| Bradley M Chapman | Emergency Medicine | Bluejacket Emergency Physicians LLC | 10500 Quivira Rd, Overland Park, KS 66215-2306 |
| Nicholas S Hosey | Emergency Medicine | Bluejacket Emergency Physicians LLC | 10500 Quivira Rd, Overland Park, KS 66215-2306 |
| Sydney A Stahlberg | Emergency Medicine | Bluejacket Emergency Physicians LLC | 10500 Quivira Rd, Overland Park, KS 66215-2306 |
| Mark O Scott | Emergency Medicine | Bluejacket Emergency Physicians LLC | 10500 Quivira Rd, Overland Park, KS 66215-2306 |
| Eliana Megerman | Emergency Medicine | Bluejacket Emergency Physicians LLC | 10500 Quivira Rd, Overland Park, KS 66215-2306 |
| Macy M Stork | Nurse Practitioner | Bluejacket Emergency Physicians LLC | 10500 Quivira Rd, Overland Park, KS 66215-2306 |
| Eric Russell Macrae | Emergency Medicine | Bluejacket Emergency Physicians LLC | 10500 Quivira Rd, Overland Park, KS 66215-2306 |
| Roger M Goldenberg | Emergency Medicine | Bluejacket Emergency Physicians LLC | 10500 Quivira Rd, Overland Park, KS 66215-2306 |
| Street Address |
13505 S ALDEN ST |
| City | OLATHE |
| State | KS |
| Zip | 66062-5840 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andrew S Dalton | Emergency Medicine | Bluejacket Emergency Physicians LLC | 13505 S Alden St, Olathe, KS 66062-5840 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anna M Dietz Henk | Clinical Social Worker | 11695 S Blackbob Rd, Olathe, KS 66062-1058 | |
| Jere Lee Mills | Chiropractic | 13795 S Mur-len Rd, Suite 203, Olathe, KS 66062-1096 | |
| Tracy S Alagna | Nurse Practitioner | Mid America Senior Management LLC | 16600 W 126th St, Villa St Francis, Olathe, KS 66062-1184 |
| Mary Sue Hardage | Clinical Social Worker | 511 N Mur Len Rd, Olathe, KS 66062-1242 | |
| Jeremy S Dulin | Chiropractic | 13095 S Mur Len Rd, Suite 170, Olathe, KS 66062-1250 | |
| Kim P Miley | Chiropractic | 13095 S Mur Len Rd, Suite 170, Olathe, KS 66062-1250 | |
| Troy I Rockers | Chiropractic | 501 N Mur Len Rd A, Olathe, KS 66062-1258 | |
| Brent L Halderman | Psychologist, Clinical | 513 N Mur Len Rd, Olathe, KS 66062-1318 | |
| Carol Sabath | Nurse Practitioner | Take Care Health Kansas Pa | 13450 S Blackbob Rd, Olathe, KS 66062-1503 |
| Callie Ballenger | Nurse Practitioner | Take Care Health Kansas Pa | 13450 S Blackbob Rd, Olathe, KS 66062-1503 |
| Find all physicians in zip 66062 | |||
| City | OLATHE |
| Zip Code | 66062 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | OLATHE + EMERGENCY MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.