JESSICA ANNE KOUPAL DNP-FNP, PMHNP
NPI 1306488333
Nurse Practitioner - Psychiatric/Mental Health in Blackhawk, SD
About Jessica Anne Koupal Dnp-fnp, Pmhnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JESSICA ANNE KOUPAL DNP-FNP, PMHNP (NPI 1306488333) is an individual psychiatric/mental health provider in Blackhawk, South Dakota, licensed in South Dakota (CP001656) and active in the NPI registry since October 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jessica Anne Koupal Dnp-fnp, Pmhnp 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.
Medicare Billing Reassignment
Medicare enrollment records show Jessica Koupal reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Black Hawk, SD 57718
- Reassigned Medicare billing, South Dakota enrollment
- 3 clinicians in this Medicare group
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 57718 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 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BLACK HAWK, SD 57718
BLACK HAWK, SD 57718
BLACK HAWK, SD 57718
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 Jessica Koupal's NPI number?
The NPI number for Jessica Koupal is 1306488333. It was assigned to this individual provider in the NPPES registry on October 10, 2019.
Where is Jessica Koupal located?
Jessica Koupal practices at 8000 Black Hawk Rd Ste 4, Blackhawk, SD 57718. The listed phone number is (605) 431-3388.
What is Jessica Koupal's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Jessica Koupal enrolled in Medicare?
Yes. Jessica Koupal is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Jessica Koupal's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jessica Koupal reassigns Medicare benefits to Mind Body Connections LLC (Black Hawk, SD). The 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 Jessica Koupal's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jessica Koupal accept?
Health plans from Sanford Health Plan, UnitedHealthcare and Wellmark of South Dakota, Inc. list Jessica Koupal as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jessica Koupal was last updated on September 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Jessica Anne Koupal, DNP-FNP, PMHNP · NPI 1306488333
Psychiatric/Mental Health physician in Blackhawk, South Dakota. Individual provider, active in the CMS NPPES registry since October 10, 2019.
## Identity
- **NPI:** 1306488333 (Entity type: Individual)
- **Enumerated:** October 10, 2019
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** CP001656 (South Dakota)
- **Sole proprietor:** No
## Practice location
- **Address:** 8000 BLACK HAWK RD STE 4, Blackhawk, SD 57718
- **Phone:** (605) 431-3388
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Mind Body Connections LLC (NPI 1295519213, Black Hawk, SD), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** September 7, 2023
---
Source: [NPI Profile](https://npiprofile.com/npi/1306488333) · Data from the CMS NPPES public registry.