Active NPI
Kraig M Koschmeder, PA-C
- Physician Assistant
- Temple Terrace, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9104860
- Practice address
- 5901 E Fowler Ave Ste 100
Temple Terrace, FL 33617-2305 - Phone
- (813) 978-9700
- Fax
- (813) 558-6185
- NPI assigned
- Mar 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA9104860 | FL | |
| Surgical Physician Assistant | 363AS0400X | PA9104860 | FL | |
| Physician Assistant | 363A00000X | PA9104860 | FL | Primary |
Addresses
Primary practice location
5901 E Fowler Ave Ste 100
Temple Terrace, FL 33617-2305
Mailing address
5901 E Fowler Ave Ste 100
Temple Terrace, FL 33617-2305
Phone (813) 978-9700
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000733800 | Medicaid | FL | |
| 373905 | Other | FL | AVMED |
| 9808066 | Other | FL | AETNA |
| P01334010 | Other | FL | RAILROAD MEDICARE |
| Y0LQ9 | Other | FL | FLORIDA BLUE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3334 Capital Medical Blvd
Suite 400
Tallahassee, FL 32308-4470
Phone (850) 877-8174
560 S Lakewood Dr
101 Florida Orthopaedic Institute
Brandon, FL 33511-5015
Phone (813) 978-9700
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001790 | IA | MD | Speech-Language Pathologist |
| PA9104860 | FL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tallahassee Orthopedic Clinic III, P.L. | Current | Accepting new patients | |
| Tallahassee Orthopedic Clinic III PL | Current | Accepting new patients | |
| Quality Drive Emergency Physicians LLC | Past | Accepting new patients | |
| Genesis Health System | Past | Accepting new patients | |
| Genesis Health System | Past | Accepting new patients |
Locations
560 S Lakewood Dr
Ste 101
Brandon, FL 33511
Phone (813) 657-8448
3334 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 210-1808
909 N Dale Mabry Hwy
Tampa, FL 33609
Phone (813) 287-9370
13060 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637
13020 N Telecom Pkwy
Temple Terrace, FL 33637
5901 E Fowler Ave
Ste 100
Temple Terrace, FL 33617
Phone (813) 987-9700
13020 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637
2044 Trinity Oaks Blvd
Ste 110
Trinity, FL 34655
Phone (813) 978-7000
2653 Bruce B Downs Blvd
Fl Orthopaedic
Wesley Chapel, FL 33544
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- kraig.koschmeder.1@18802.direct.athenahealth.com
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.
-
- Medical Specialty Clinic/Center
- Tallahassee, FL
- NPI 1194778050
-
- Orthopaedic Surgery Physician
- Temple Terrace, FL
- NPI 1386639920
-
- Durable Medical Equipment & Medical Supplies
- Panama City Beach, FL
- NPI 1497617948
-
- Emergency Medicine Physician
- Spring Hill, FL
- NPI 1093998833
-
- Clinic/Center
- Davenport, IA
- NPI 1205860400
-
- Clinic/Center
- Bettendorf, IA
- NPI 1497772008
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744675200000",
"number": "1245368158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5901 E FOWLER AVE STE 100",
"city": "TEMPLE TERRACE",
"state": "FL",
"postal_code": "336172305",
"telephone_number": "813-978-9700",
"fax_number": "813-558-6185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5901 E FOWLER AVE STE 100",
"city": "TEMPLE TERRACE",
"state": "FL",
"postal_code": "336172305",
"telephone_number": "813-978-9700",
"fax_number": "813-558-6185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOSCHMEDER",
"first_name": "KRAIG",
"middle_name": "M",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-01",
"last_updated": "2025-04-15",
"certification_date": "2025-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA9104860",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "FL",
"license": "PA9104860",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9104860",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000733800",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "373905",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "9808066",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01334010",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA BLUE",
"identifier": "Y0LQ9",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Temple Terrace, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.