Individual provider Active NPI

John S Koppman, M.D.

  • Surgery Physician
  • St Augustine, FL
National Provider Identifier
1952364713
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME0093820 Issued in FL
Practice address
201 Health Park Blvd
Suite 103
St Augustine, FL 32086-5796
Phone
(904) 827-0093
NPI assigned
Apr 11, 2006
Last updated
Aug 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME0093820 FL Primary

Addresses

Primary practice location

201 Health Park Blvd
Suite 103
St Augustine, FL 32086-5796

Mailing address

PO Box 100286
Gainesville, FL 32610-0286
Phone (352) 265-0535

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone (352) 265-0535

Other practice location 2

600 E Dixie Ave
Leesburg, FL 34748-5925
Phone (352) 265-0535

Other practice location 3

400 Health Park Blvd
St Augustine, FL 32086-5784
Phone (352) 265-0535

Other identifiers 1

IdentifierTypeStateIssuer
273240800MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050831000738 FL Practitioner - General Surgery 7214969187 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0093820FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John S. Koppman MD PL Surgery CurrentSince Sep 18, 2013 Accepting new patients
U.S. Bariatric, Orlando, LLC Surgery Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

201 Health Park Blvd
Ste 103
St Augustine, FL 32086
Phone (904) 547-2808

Interoperability endpoints

  • Direct secure messaging: jkoppman744033@direct.shands.ufl.edu

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1952364713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100286",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100286",
            "telephone_number": "352-265-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 HEALTH PARK BLVD",
            "address_2": "SUITE 103",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865796",
            "telephone_number": "904-827-0093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103003",
            "country_code": "US",
            "telephone_number": "352-265-0535",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 E Dixie Ave",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "FL",
            "postal_code": "347485925",
            "country_code": "US",
            "telephone_number": "352-265-0535",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Health Park Blvd",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865784",
            "country_code": "US",
            "telephone_number": "352-265-0535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOPPMAN",
        "first_name": "JOHN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME0093820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273240800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.