JENNIFER KOELLER PA-C - NPI 1043625809 - Physician Assistant in Leesburg, FL

Q: What is Jennifer Koeller's NPI number?

The NPI number for Jennifer Koeller is 1043625809. It was assigned to this individual provider in the NPPES registry on June 30, 2014.

Q: What is Jennifer Koeller's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Koeller was last updated on April 1, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Jennifer Koeller Pa-c NPPES

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

JENNIFER KOELLER PA-C (NPI 1043625809) is an individual surgical provider in Leesburg, Florida, licensed in Florida (PA9108194) and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS, is affiliated with Holmes Regional Medical Center, and maintains a secondary practice location in Melbourne.

NPPES Registry Identity

NPI1043625809

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameJENNIFER KOELLERCredential: PA-C

Location Address700 DOCTORS CTLeesburg, FL 34748-7314

Mailing AddressPo Box 3130Ocala, FL 34478-3130 · (352) 867-3262 · Fax (352) 622-5771

Phone(352) 787-9838

Fax(352) 787-8705

Sole ProprietorYes

Medical School CMSOtherGraduated 2014

Enumeration DateJune 30, 2014

Last NPPES UpdateApril 1, 20254 updates tracked since enumeration

NPPES CertifiedApril 1, 2025

✔ NPI 1043625809 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in FL · PA9108194

Also ListedPhysician AssistantTaxonomy 363A00000X · License 25MP00337400 (NJ)

700 DOCTORS CT, Leesburg, FL 34748

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Secondary Practice Location 1

Location 11350 Hickory StMelbourne, FL 32901-3224 · Phone (321) 434-3455

Other Identifiers 3

OtherPA9108194FL · Medical License

OtherUM361FL · Medicare Hf

Medicaid117870300FL

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

Jennifer Koeller Pa-c 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 ID5597048249

PECOS Enrollment IDI20170203001468

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.

Hospital Affiliations CMS Care Compare

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

Holmes Regional Medical Center

Acute Care Hospitals · Melbourne, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100019

Location1350 S Hickory StMelbourne, FL 32901 · Brevard County

Emergency services Birthing friendly

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.

78.01/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

57.51

Promoting Interoperability

100

Improvement Activities

Cost

69.18

Other Providers at the Same Location NPPES 12

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

JEAN EMILCAR M.D.

Anesthesiology