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MR. LEON KOENCK PA C
NPI 1164555769
Physician Assistant in Gualala, CA

Active since March 13, 2007PECOS Enrolled
73.79/100
CMS Quality Rating
46900 OCEAN DR, STE 1100, GUALALA, CA 95445(707) 884-4005(707) 884-4625 Get Directions Write a Review

NPPES record last updated: February 2, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Leon Koenck Pa C NPPES

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

MR. LEON KOENCK PA C (NPI 1164555769) is an individual physician assistant in Gualala, California, licensed in California (PA19714) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164555769
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. LEON KOENCKCredential: PA C
Location Address46900 OCEAN DR, STE 1100Gualala, CA 95445-8353
Mailing Address200 West 34th Avenue, #539Anchorage, AK 99503 · (888) 300-0137 · Fax (888) 300-0137
Phone(707) 884-4005
Fax(707) 884-4625
Sole ProprietorNo
Enumeration DateMarch 13, 2007
Last NPPES UpdateFebruary 2, 2016
✔ NPI 1164555769 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses✔ Licensed in CA · PA19714✔ Licensed in AK · 270✔ Licensed in WA · PA 10003212
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA19714 (CA), PA10003212 (WA)
46900 OCEAN DR, Gualala, CA 95445
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Other Identifiers 1

Medicare UPINS86261

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Leon Koenck Pa C is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95445 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
$90.32 typical visit price
range $58.87 – $176.60
Typical copayment $22.58 (range $14.71 – $44.15)
Most-billed visit code 99203
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
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.

73.79/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality76.87
Promoting Interoperability92
Improvement Activities40
Cost36.93

Other Providers at the Same Location NPPES 10

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

LAUNDON TRANSUE
Physician Assistant
46900 OCEAN DR
GUALALA, CA 95445
Mendocino County (707) 884-4005
DR. MARK KAL M.D.
Family Medicine
46900 OCEAN DR
GUALALA, CA 95445
Mendocino County (707) 884-4005
LOIS FALK N.P.
Nurse Practitioner
46900 OCEAN DR
GUALALA, CA 95445
Mendocino County (707) 884-4005
ADELE ZITA RN
Registered Nurse
46900 OCEAN DR
GUALALA, CA 95445
Mendocino County (707) 884-4005
NORTHERN CALIFORNIA MEDICAL ASSOC INC
Internal Medicine (Cardiovascular Disease)
46900 OCEAN DR
GUALALA, CA 95445
Mendocino County (707) 573-6166
ROBERTA U. RAMS D.D.S.
Dentist (General Practice)
46900 OCEAN DR
GUALALA, CA 95445
Mendocino County (707) 884-4005
CAITHLEEN PATERSON ZIKORUS N.P.
Nurse Practitioner (Family)
46900 OCEAN DR
GUALALA, CA 95445
Mendocino County (707) 884-4005
ELIZABETH J NAGLE FNP
Nurse Practitioner (Family)
46900 OCEAN DR
GUALALA, CA 95445
Mendocino County (707) 884-4005

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 Leon Koenck's NPI number?

The NPI number for Leon Koenck is 1164555769. It was assigned to this individual provider in the NPPES registry on March 13, 2007.

Where is Leon Koenck located?

Leon Koenck practices at 46900 Ocean Dr Ste 1100, Gualala, CA 95445. The listed phone number is (707) 884-4005.

What is Leon Koenck's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Leon Koenck enrolled in Medicare?

Yes. Leon Koenck is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Leon Koenck was last updated on February 2, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.