Individual provider Active NPI

Crystal Pickeral Koerner, M.D.

  • Colon & Rectal Surgery Physician
  • Seattle, WA
National Provider Identifier
1235524703
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
61033333 Issued in WA
Practice address
1101 Madison St Ste 500
Seattle, WA 98104-3557
Phone
(206) 386-6600
NPI assigned
Apr 1, 2015
Last updated
Sep 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 61033333 WA Primary

Addresses

Primary practice location

1101 Madison St Ste 500
Seattle, WA 98104-3557

Mailing address

1101 Madison St Ste 500
Seattle, WA 98104-3557
Phone (206) 386-6600

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210608003204 GA Practitioner - Colorectal Surgery (Proctology) 5597165829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Florida State University College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Colorectal Associates, PCGroup PAC ID 1052323839, 7 clinicians

Practice addresses (Care Compare)

35 Collier Rd NW
Suite 475
Atlanta, GA 30309-1605
Phone (404) 351-7900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61033333WAMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Colorectal Associates, PC Single Specialty CurrentSince Feb 28, 2021 Accepting new patients

Locations

35 Collier Rd NW
Ste 475
Atlanta, GA 30309
Phone (404) 351-7900

Organizations & group practices 1

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

Hospital & facility affiliations 1

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": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1235524703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST STE 500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043557",
            "telephone_number": "206-386-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST STE 500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043557",
            "telephone_number": "206-386-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOERNER",
        "first_name": "CRYSTAL",
        "middle_name": "PICKERAL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "WA",
            "license": "61033333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.