BREANNA MARIE KOETTER MD
NPI 1013597236
Radiology - Diagnostic Radiology in Charleston, SC
About Breanna Marie Koetter Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BREANNA MARIE KOETTER MD (NPI 1013597236) is an individual diagnostic radiology provider in Charleston, South Carolina, licensed in South Carolina (MMD88280MD) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and is a graduate of Creighton University School Of Medicine (2021).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Breanna Marie Koetter Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
4Medicare enrollment records show Breanna Koetter reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Charleston, SC 29425
- Reassigned Medicare billing, South Carolina enrollment
- 2,594 clinicians in this Medicare group
Bamberg, SC 29003
- Reassigned Medicare billing, South Carolina enrollment
- 2,389 clinicians in this Medicare group
Peoria, IL 61637
- Reassigned Medicare billing, South Carolina enrollment
Escanaba, MI 49829
- Reassigned Medicare billing, South Carolina enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 29425 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CHARLESTON, SC 29425
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Breanna Koetter's NPI number?
The NPI number for Breanna Koetter is 1013597236. It was assigned to this individual provider in the NPPES registry on April 12, 2021.
Where is Breanna Koetter located?
Breanna Koetter practices at 171 Ashley Ave, Charleston, SC 29425. The listed phone number is (843) 792-1414.
What is Breanna Koetter's specialty?
The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.
Is Breanna Koetter enrolled in Medicare?
Yes. Breanna Koetter is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Breanna Koetter's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Breanna Koetter reassigns Medicare benefits to 4 organizations: University Medical Associates Of The Medical University Of South Carol (Charleston, SC), Musc Community Physicians (Bamberg, SC), Central Illinois Radiological Associates, Ltd. (Peoria, IL) and Cira Michigan PC (Escanaba, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Breanna Koetter's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Breanna Koetter was last updated on April 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Breanna Marie Koetter, MD · NPI 1013597236
Diagnostic Radiology physician in Charleston, South Carolina. Individual provider, active in the CMS NPPES registry since April 12, 2021.
## Identity
- **NPI:** 1013597236 (Entity type: Individual)
- **Enumerated:** April 12, 2021
- **Primary specialty:** Radiology - Diagnostic Radiology · taxonomy 2085R0202X
- **State license:** MMD88280MD (South Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 171 ASHLEY AVE, Charleston, SC 29425-0100
- **Phone:** (843) 792-1414
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): University Medical Associates Of The Medical University Of South Carol (NPI 1013934629, Charleston, SC); Musc Community Physicians (NPI 1841878006, Bamberg, SC); Central Illinois Radiological Associates, Ltd. (NPI 1538192828, Peoria, IL); Cira Michigan PC (NPI 1972141513, Escanaba, MI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Creighton University School Of Medicine, class of 2021
## Record status
- **NPPES last updated:** April 1, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1013597236) · Data from the CMS NPPES public registry.