Jeffrey Allan Koller, PA-C is a medicare enrolled "Physician Assistant" in Sublimity, Oregon. His current practice location is
114 Se Church St, Sublimity, Oregon. You can reach out to his office (for appointments etc.) via phone at
(503) 769-2259.
Jeffrey Allan Koller is licensed to practice in Oregon (license number PA218511) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1215790639.
Provider's Profile
Full Name | Jeffrey Allan Koller |
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Gender | Male |
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Speciality | Physician Assistant |
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Location | 114 Se Church St, Sublimity, Oregon |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1215790639
- Provider Enumeration Date: 01/31/2024
- Last Update Date: 01/31/2024
Medicare PECOS Information:
- PECOS PAC ID: 0749629681
- Enrollment ID: I20240411003577
Medical Identifiers
Medical identifiers for Jeffrey Allan Koller such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1215790639 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | PA218511 (Oregon) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jeffrey Allan Koller is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jeffrey Allan Koller, PA-C 4847 Verda Ln Ne Apt 302, Keizer, OR 97303 Ph: (605) 760-0590 | Jeffrey Allan Koller, PA-C 114 Se Church St, Sublimity, OR 97385-9424 Ph: (503) 769-2259 |
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