Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ryan Taylor Koch, PA

Individual provider Physician Assistant · NPI 1770092967

Ryan Taylor Koch, PA is a Physician Assistant in Mineola, New York. Qualified in 2017, 9 years ago. Practices with New York University, a 5,884-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
9
In the registry since
2017
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

259 1st St
Mineola, NY 11501-3957
Phone: (516) 663-0333
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1000 Montauk Hwy, West Islip, NY 11795-4927 — (631) 376-4444

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1770092967
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 20, 2017
Last updated in NPPESAugust 22, 2022
Certification dateAugust 22, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice New York University — 5884 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

Other providers in Mineola