Lisa Koop, in Fort Wayne, IN - Medicare Nurse Anesthetist, Certified Registered

Lisa Koop, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Fort Wayne, Indiana. Her current practice location is 5050 N Clinton St, Fort Wayne, Indiana. You can reach out to her office (for appointments etc.) via phone at (260) 484-8551.

Lisa Koop is licensed to practice in Indiana (license number 28193681A) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1265160881.

Contact Information

	Lisa Koop,
	5050 N Clinton St, Fort Wayne, IN 46825-5886
	(260) 484-8551
	Not Available

Map and Direction

Provider's Profile

Full Name	Lisa Koop
Gender	Female
Speciality	Nurse Anesthetist, Certified Registered
Location	5050 N Clinton St, Fort Wayne, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1265160881
Provider Enumeration Date: 08/11/2022
Last Update Date: 08/11/2022

Medicare PECOS Information:

PECOS PAC ID: 2062888720
Enrollment ID: I20221020001618

Medical Identifiers

Medical identifiers for Lisa Koop such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1265160881	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	28193681A (Indiana)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lisa Koop allows following entities to bill medicare on her behalf.

Entity Name	Surgery One Anesthesia Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1144724402 PECOS PAC ID: 8820351463 Enrollment ID: O20180413001005

Entity Name	Anesthesia Dynamics Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073001012 PECOS PAC ID: 3779832530 Enrollment ID: O20191011000052

Entity Name	Northern Indiana Anesthesia Associates, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1033891510 PECOS PAC ID: 6709234750 Enrollment ID: O20231130003347

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. Lisa Koop 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
Lisa Koop, 5052 N Clinton St, Fort Wayne, IN 46825-5822 Ph: () -	Lisa Koop, 5050 N Clinton St, Fort Wayne, IN 46825-5886 Ph: (260) 484-8551

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Fort Wayne, IN

Anthony Dzigbordi, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 5050 N Clinton St, Fort Wayne, IN 46825 Phone: 260-484-8551
Lisa A Tompa, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 5050 N Clinton St, Fort Wayne, IN 46825 Phone: 260-484-8551 Fax: 260-482-5060
Nicole Borem Schickel, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 5734 Coventry Ln, Fort Wayne, IN 46804 Phone: 260-436-7875
Blair John Walker, RN, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 7950 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-416-3000
Madeline Sikes Brooks, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 10315 Dawsons Creek Blvd Ste Ab, Fort Wayne, IN 46825 Phone: 260-436-7875 Fax: 260-432-9812
Dr. Jennifer Hager, DNP, MBA, CRNA Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 10315 Dawsons Creek Blvd Ste Ab, Fort Wayne, IN 46825 Phone: 260-436-7875 Fax: 260-432-9812
Lisa Osborne, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 5734 Coventry Ln, Fort Wayne, IN 46804 Phone: 260-436-7875

Lisa Koop, - Medicare Nurse Anesthetist, Certified Registered in Fort Wayne, IN