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

Thomas Michael Koch, PA-C

Individual provider Physician Assistant · NPI 1720859150

Thomas Michael Koch, PA-C is a Physician Assistant in Chicago, Illinois. Qualified in 2023, 3 years ago. Practices with Cepamerica Illinois LLP, a 493-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
3
Licensed in
IL
In the registry since
2024
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4646 N Marine Dr
Chicago, IL 60640-5759
Phone: (773) 878-8700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085.010261 (IL)
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1720859150
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJanuary 15, 2024
Last updated in NPPESMarch 6, 2026
Certification dateMarch 6, 2026
Mailing address1242 N Bosworth Ave Apt 1f, Chicago, IL 60642-3356

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Cepamerica Illinois Llp — 493 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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