William R Koopal, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9568 Issued in GA

Practice address

2403 Osler CT Ste a
Albany, GA 31707-0205

Phone

(229) 405-6196

Fax

(229) 261-1334

NPI assigned

Oct 21, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Albany Area Primary Health Care, IncGroup PAC ID 7911811922, 59 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Bachelor of Science, Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: will.koopal@aaphc.eclinicaldirectplus.com

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.

• Albany Area Primary Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Albany, GA
  • NPI 1780608992
  Medicare reassignment Care Compare group
• Albany Area Primary Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Albany, GA
  • NPI 1013709625
  NPD
• Albany Area Primary Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Albany, GA
  • NPI 1902277635
  NPD
• Albany Area Primary Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Albany, GA
  • NPI 1023043692
  NPD (past)

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

{
    "created_epoch": "1540080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1184190837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N WESTOVER BLVD",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317072983",
            "telephone_number": "229-888-6559",
            "fax_number": "229-436-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 OSLER CT STE A",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317070205",
            "telephone_number": "229-405-6196",
            "fax_number": "229-261-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOPAL",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-21",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Knoefler, M.D.
• David Livingstone Kocherla, MD
• Shiny Teja Kolli, MD
• Edward Kojo-Eyiah Koomson, M.D.
• Alyssa Nicole Koopal, PA
• Joel John Koshy, DO
• Theresa Libo-on Kowalski, M.D.
• Mika Rivers Krewer, LPC
• Andrea Jane Kromminga
• Robert Krywicki, MD

• Physician Assistant in Albany, GA
• Providers in Albany, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.