Individual provider Active NPI

Elena Koepke, M.D.

  • Anesthesiology Physician
  • Houston, TX
National Provider Identifier
1194161307
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
R4417 Issued in TX
Practice address
6431 Fannin St RM 5.181
Houston, TX 77030-1501
Phone
(713) 500-5228
Fax
(713) 500-0648
NPI assigned
May 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X R4417 TX Primary

Addresses

Primary practice location

6431 Fannin St RM 5.181
Houston, TX 77030-1501

Mailing address

PO Box 301173
Dallas, TX 75303-1173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MD, DC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200423001229 TX Practitioner - Anesthesiology 9133485576 Reassigns benefits to 1 organization
I20230719000456 MD Practitioner - Anesthesiology 9133485576 Reassigns benefits to 2 organizations
I20230719000827 DC Practitioner - Anesthesiology 9133485576 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Tulane University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

3800 Reservoir Rd NW
Washington, DC 20007-2113
Phone (703) 558-1400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R4417TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group Anesthesiology LLC Anesthesiology CurrentSince Jun 5, 2023 Accepting new patients
Ut Physicians Anesthesiology CurrentSince Apr 20, 2020 Accepting new patients
Ut Physicians CurrentSince Apr 20, 2020 Accepting new patients
Medstar Medical Group Anesthesiology LLC Anesthesiology CurrentSince Jun 5, 2023 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

3007 Tilden St NW
Ste 5N
Washington, DC 20008

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

25500 Point Lookout Rd
Leonardtown, MD 20650
Phone (301) 475-6106

9000 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 682-7000

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

6431 Fannin St
Rm 5181
Houston, TX 77030
Phone (713) 500-5228

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1194161307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 301173",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753031173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST RM 5.181",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-5228",
            "fax_number": "713-500-0648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEPKE",
        "first_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-14",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "R4417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.