Michael Koeppen, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036064957 Issued in IL

Practice address

221 NE Glen Oak Ave
Peoria, IL 61603-4307

Phone

(309) 672-5522

NPI assigned

Apr 4, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Family PracticeAlso: Emergency Medicine

Education

Northwestern University Feinberg Medical School, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hillsboro Area Hospital, Inc.Group PAC ID 4486547148, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hillsboro Area Hospital Hospital, Hillsboro, IL, CCN 141332

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Hillsboro Area Hospital, Inc.

  • Hospitalist Physician
  • Hillsboro, IL
  • NPI 1821078213

  IL

  Medicare reassignment Care Compare group NPD
• Integritas Emergency Physician Services, LLC

  • Emergency Medicine Physician
  • Carbondale, IL
  • NPI 1790128817

  IL

  Medicare reassignment NPD
• Hillsboro Area Hospital, Inc.

  • Critical Access Hospital
  • Hillsboro, IL
  • NPI 1194705210

  IL

  Medicare reassignment
• Hillsboro Area Hospital, Inc.

  • Rural Health Clinic/Center
  • Hillsboro, IL
  • NPI 1811774771
  NPD

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

• Hillsboro Area Hospital, Inc.

  • Critical Access Hospital
  • Hillsboro, IL
  • NPI 1194705210

  Hospital

  Care Compare affiliation
• Hillsboro Area Hospital, Inc.

  • Rural Health Clinic/Center
  • Hillsboro, IL
  • NPI 1811774771

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1679535728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21276 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731212",
            "telephone_number": "877-485-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616034307",
            "telephone_number": "309-672-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEPPEN",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036064957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036064957",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "36064957",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00195431",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gail A Koch, M.A., L.C.P.C.
• Jennifer Koch
• Rachel A Koch, PTA
• Miranda Kocher, M.S. CCC-SLP/L
• Marysue Patricia Koelling
• Truc-Quynh D Kohlmeyer
• Stephanie Kok, M.D.
• Jennifer Lee Kolettis, NP-C
• Yannis N Kolettis, M.D.
• Venkat Yashaswi Kondapalli

• All providers in Peoria, IL
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.