Keith Kopisch, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.024656 Issued in OH

Practice address

1000 E Washington St
Medina, OH 44256-2170

Phone

(330) 725-1000

NPI assigned

May 14, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medina HospitalGroup PAC ID 3072410125, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medina Hospital Hospital, Medina, OH, CCN 360091
• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Medina Hospital

  • General Acute Care Hospital
  • Medina, OH
  • NPI 1083696710
  Medicare reassignment Care Compare group NPD
• Medina Hospital

  • Emergency Medicine Physician
  • Brunswick, OH
  • NPI 1174586150
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Medina Hospital

  • General Acute Care Hospital
  • Medina, OH
  • NPI 1083696710
  Care Compare affiliation
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1124684220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E WASHINGTON ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E WASHINGTON ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562170",
            "telephone_number": "330-725-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPISCH",
        "first_name": "KEITH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-14",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.024656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Kolodziej, OTR/L
• Jerry Stanley Kolosionek, DDS
• John Komara III, PHARM.D.
• Kontoveros Klobas Medina LLC
• Jonathan Dean Kopen, PTA
• Heather Kopkas, QMHS, CMS
• Candice Gabrielle Kordich
• Samantha Kost, MSW, LISW
• Zen Kotori, LMT
• Lisa Ann Kovach, RDN

• Family Nurse Practitioner in Medina, OH
• Providers in Medina, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.