MS. MADALYN JEAN KOCH APRN
NPI 1881145365
Nurse Practitioner - Family in Cincinnati, OH
NPI Status: Active since October 19, 2016
- Individual
- Female
- Nurse Practitioner
- Family
- Accepts Insurance
- PECOS Enrolled
About MADALYN KOCH
This page provides the complete NPI Profile along with additional information for Madalyn Koch, a provider established in Cincinnati, Ohio with a medical specialization in Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1881145365 assigned on October 2016. The practitioner's primary taxonomy code is 363LF0000X with license number LE-00041276 (OH). The provider is registered as an individual and her NPI record was last updated 3 years ago.
- NPI
- 1881145365
- Provider Name
- MS. MADALYN JEAN KOCH APRN
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 331 W 4TH ST CINCINNATI, OH 45202
- Location Phone
- (614) 500-7000
- Mailing Address
- 331 W 4TH ST CINCINNATI, OH 45202
- Mailing Phone
- (614) 500-7000
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-19-2016
- Last Update Date
- 07-25-2022
- Code Navigator
A nurse practitioner (NP) like Madalyn Koch is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- LE-00041276
- License State
- OH
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | APRN 20536 (SC) |
| 2 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 11674-33 (WI) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Direction Silver 1 - POS
- Blue Direction Silver 1 + Adult Vision - POS
- Blue Direction Silver 2 - POS
- Blue Direction Standard Gold - POS
- Blue Direction Standard Silver - POS
- Blue Reedy Bronze 1 - HMO
- Blue Reedy Bronze 2 - HMO
- Blue Reedy Gold 1 - HMO
- Blue Reedy Silver 1 - HMO
- Blue Reedy Silver 2 - HMO
- Blue Reedy Silver 2 + Adult Vision - HMO
- Blue Reedy Standard Expanded Bronze - HMO
- Blue Reedy Standard Gold - HMO
- Blue Reedy Standard Silver - HMO
- Blue VirtuConnect Bronze 1 - EPO
- Blue VirtuConnect Gold 1 - EPO
- Blue VirtuConnect Silver 1 - EPO
- BlueEssentials Bronze 4 - EPO
- BlueEssentials Bronze 6 - EPO
- BlueEssentials Catastrophic 1 - EPO
- Bronze First 7500 $25 Generic Drugs - HMO
- Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Gold 1500 $15 Generic Drugs - HMO
- Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
- HDHP Preventive Silver 5500 $0 Select Drugs - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- HSA Eligible Bronze 6000 - HMO
- Low Premium Bronze 9200 $25 Generic Drugs - HMO
- Low Premium Bronze 9200 $25 Generic Drugs Adult Vision & Fitness - HMO
- Low Premium Silver 6000 $3 Generic Drugs - HMO
- Low Premium Silver 6000 $3 Generic Drugs Adult Vision & Fitness - HMO
- Platinum Zero $5 Generic Drugs - HMO
- Platinum Zero $5 Generic Drugs Adult Vision & Fitness - HMO
- InHealth Basic 1 - HMO
- InHealth Basic 1 + Adult Vision - HMO
- InHealth Basic 2 - HMO
- InHealth Basic Plus Standard - HMO
- InHealth Basic Standard - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Madalyn Koch is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Aspiration and/or injection of fluid from large joint
Emergency department visit for problem of high severity
Injection, methylprednisolone acetate, 40 mg
Injection, triamcinolone acetonide, not otherwise specified, 10 mg
X-ray of knee, 3 views
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.
This service was performed 38 times for 36 patientsAn emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
This service was performed 23 times for 23 patientsMethylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.
This service was performed 48 times for 15 patientsTriamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
This service was performed 176 times for 16 patientsAn X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.
This service was performed 20 times for 20 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 45202 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.72
- Minimum New Patient Price $54.34
- Maximum New Patient Price $166.65
- Average New Patient Copayment $21.18
- Minimum New Patient Copayment $13.58
- Maximum New Patient Copayment $41.66
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $96.44
- Minimum Established Patient Price $17.1
- Maximum Established Patient Price $135.4
- Average Established Patient Copayment $24.11
- Minimum Established Patient Copayment $4.27
- Maximum Established Patient Copayment $33.85
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 8 | 8 | 1 | 1 | 4 | 5 | 3 | 6 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 16 | 1 | 2 | 4 | 10 | 3 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 1 + 6 + 1 + 2 + 4 + 1 + 0 + 3 + 1 + 2 + 24 = 55 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 55 = 5 | 5 | ||||||||
The NPI number 1881145365 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1790315265 | LISA MARIE MCMILLAN NP Individual | Registered Nurse (Women's Health Care, Ambulatory) | 331 W 4TH ST CINCINNATI, OH 45202 (513) 675-7111 |
| 1053904318 | LAUREN GRAU APRN Individual | Dermatology (Procedural Dermatology) | 331 W 4TH ST CINCINNATI, OH 45202 (614) 500-7000 |
| 1477110518 | NICOLE CORDERO Individual | Nurse Practitioner (Family) | 331 W 4TH ST CINCINNATI, OH 45202 (614) 500-7000 |
| 1932780624 | ALLYSON C HUGHES FNP-C Individual | Nurse Practitioner | 331 W 4TH ST CINCINNATI, OH 45202 (513) 504-7637 |
| 1851024905 | BRITTNEY SNYDER Individual | Nurse Practitioner | 331 W 4TH ST CINCINNATI, OH 45202 (614) 500-7000 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1881145365, enumerated in the NPI registry as an "individual" on October 19, 2016
The provider is located at 331 W 4th St Cincinnati, Oh 45202 and the phone number is (614) 500-7000
The provider's speciality is Nurse Practitioner with taxonomy code 363LF0000X with a focus in Family
The provider might be accepting Accepts: BlueCross BlueShield of South Carolina, CareSource. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $84.72 with an average copayment of $21.18 for new patient appointments. Established patients should expect a typical charge of $96.44 and an average copayment of 24.11. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Aspiration and/or injection of fluid from large joint, Emergency department visit for problem of high severity, Injection, methylprednisolone acetate, 40 mg, Injection, triamcinolone acetonide, not otherwise specified, 10 mg and X-ray of knee, 3 views.
This NPI record was last updated on October 19, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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