DR. DAVID WERNER KOELSCH MD
NPI 1013919489
Surgery in Oak Ridge, TN

Q: What is David Koelsch's NPI number?

The NPI number for David Koelsch is 1013919489. It was assigned to this individual provider in the NPPES registry on August 15, 2005.

Q: What is David Koelsch's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for David Koelsch was last updated on May 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.

Active since August 15, 2005PECOS EnrolledAccepts Medicare Assignment

120 ADMINISTRATION RD, OAK RIDGE, TN 37830(865) 483-7030(865) 483-3954 Get Directions Write a Review

NPPES record last updated: May 2, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 2, 2022, Apr 26, 2022, Jun 13, 2018 (3 updates tracked since 2018).

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About Dr. David Werner Koelsch Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DAVID WERNER KOELSCH MD (NPI 1013919489) is an individual surgery provider in Oak Ridge, Tennessee, licensed in Tennessee (47206) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Methodist Medical Center Of Oak Ridge, and is a graduate of University Of Tennessee, Hsc, College Of Medicine (1996).

NPPES Registry Identity

NPI1013919489

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameDR. DAVID WERNER KOELSCHCredential: MD

Location Address120 ADMINISTRATION RDOak Ridge, TN 37830-8822

Mailing Address120 Administration RdOak Ridge, TN 37830-8822 · (865) 483-7030 · Fax (865) 483-3954

Phone(865) 483-7030

Fax(865) 483-3954

Sole ProprietorNo

Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 1996

Enumeration DateAugust 15, 2005

Last NPPES UpdateMay 2, 20223 updates tracked since enumeration

NPPES CertifiedMay 2, 2022

✔ NPI 1013919489 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

Licenses✔ Licensed in TN · 47206✔ Licensed in KY · 36460

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

120 ADMINISTRATION RD, Oak Ridge, TN 37830

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Other Identifiers 2

MedicaidQ073499TN

Other000000191916KY · Bc/bs Pin #

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. David Werner Koelsch Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9234190646

PECOS Enrollment IDI20220428000271

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

106 services37 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

61 services61 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

48 services45 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

46 services33 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

21 services20 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

17 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Methodist Medical Center Of Oak Ridge

Acute Care Hospitals · Oak Ridge, TN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440034

Location990 Oak Ridge Turnpike Box 529Oak Ridge, TN 37830 · Anderson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37830 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

6%584 patients1/55-star benchmark: 100%

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

0%894 patients1/55-star benchmark: 99%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

100%3,191 patients5/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

66%124 patients3/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

98%155 patients4/55-star benchmark: 100%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

92%100 patients4/55-star benchmark: 100%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

99%509 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce A4394

DME-Orthotic Devices · category DF010N

1 supplier12 claims192 services$2.40 avg. paid by Medicare

Ostomy skin barrier, pectin-based, paste, per ounce A4406

DME-Orthotic Devices · category DF010N

2 suppliers19 claims76 services$5.02 avg. paid by Medicare

Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each A4414

DME-Orthotic Devices · category DF010N

2 suppliers15 claims300 services$4.50 avg. paid by Medicare

Adhesive remover, wipes, any type, each A4456

DME-Medical/Surgical Supplies · category DA000N

2 suppliers13 claims704 services$0.22 avg. paid by Medicare

Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each A5063

DME-Orthotic Devices · category DF010N

2 suppliers24 claims480 services$2.33 avg. paid by Medicare

Skin barrier, wipes or swabs, each A5120

DME-Orthotic Devices · category DF010N

2 suppliers11 claims550 services$0.19 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASHLEY DAY

Surgery