Nicholas Kevin Koep, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

47601 Grand River Ave
Novi, MI 48374-1233

Phone

(248) 465-4100

NPI assigned

Aug 29, 2024

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

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nkoep1134988@direct.hfhs.org

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.

• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  Physician Assistant

  Medicare reassignment NPD
• Independent Emergency Physicians, P.C.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Southfield, MI
  • NPI 1780791343
  Medicare reassignment

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

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1851125199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37000 GRAND RIVER AVE STE 310",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483352868",
            "telephone_number": "605-291-6805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47601 GRAND RIVER AVE",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741233",
            "telephone_number": "248-465-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEP",
        "first_name": "NICHOLAS",
        "middle_name": "KEVIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-10-04",
        "certification_date": "2024-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Koch-Mercer
• Kelsey Lauren Koch, FNP-C
• Rajesh Koduru
• Kimmarie Koehler
• Danielle Koenig
• Sona Koeul
• Michael Koftinow
• Edward Kohler
• Robert Matthew Koivunen, D.P.M.
• Ramachandra B Kolachalam, MD

• Physician Assistant in Novi, MI
• Providers in Novi, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.