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PROF. TAKASHI KOYAMA DMD, PHD FACS
NPI 1356459028
Oral & Maxillofacial Surgery in Fort Pierce, FL

Active since August 25, 2006PECOS EnrolledAccepts Medicare Assignment
2402 FRIST BLVD STE 100, FORT PIERCE, FL 34950(772) 461-9700(772) 461-9300 Get Directions Write a Review

NPPES record last updated: July 16, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Prof. Takashi Koyama Dmd, Phd Facs NPPES

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

PROF. TAKASHI KOYAMA DMD, PHD FACS (NPI 1356459028) is an individual oral & maxillofacial surgery provider in Fort Pierce, Florida, licensed in Florida (DN16376) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Cleveland Clinic Martin North Hospital, and is a graduate of Perelman School Of Med At The University Of Pennsylvania (2000).

NPPES Registry Identity

NPI1356459028
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NamePROF. TAKASHI KOYAMACredential: DMD, PHD FACS
Location Address2402 FRIST BLVD STE 100Fort Pierce, FL 34950-4838
Mailing Address2402 Frist Blvd Ste 100Fort Pierce, FL 34950-4838 · (772) 461-9700 · Fax (772) 461-9300
Phone(772) 461-9700
Fax(772) 461-9300
Sole ProprietorNo
Medical School CMSPerelman School Of Med At The University Of PennsylvaniaGraduated 2000
Enumeration DateAugust 25, 2006
Last NPPES UpdateJuly 16, 2019
✔ NPI 1356459028 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in FL · DN16376
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License DN16376 (FL)
2402 FRIST BLVD STE 100, Fort Pierce, FL 34950
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Other Identifiers 1

OtherDN 16376FL · Medical License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, Anthem Blue Cross and Blue Shield and more.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

Prof. Takashi Koyama Dmd, Phd Facs 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 ID4880668417
PECOS Enrollment IDI20040820000437
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.

Medicare Billing Reassignment

Medicare enrollment records show Takashi Koyama reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Takashi Koyama Dmd Phd PA
Same address
Oral & Maxillofacial Surgery
2402 FRIST BLVD STE 100
Fort Pierce, FL 34950
  • Reassigned Medicare billing, Florida enrollment
NPI 1558429753 (772) 461-9700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

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.

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.
36 services36 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.
32 services32 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.
31 services23 patients
X-ray of lower jaws, upper jaws and teeth 70355
An X-ray of lower jaws, upper jaws, and teeth is a diagnostic procedure that uses radiation to create images of these areas. This helps in identifying issues like tooth decay, gum problems, or jawbone irregularities. It's a quick, painless process and crucial for maintaining oral health.
28 services28 patients
X-ray of jaw joints on both sides of mouth 70330
An X-ray of jaw joints on both sides of the mouth, also known as a TMJ X-ray, helps visualize the structure and condition of your jaw joints. This non-invasive procedure involves capturing images using a small amount of radiation. It aids in diagnosing issues like arthritis, dislocation, or other abnormalities in the jaw area.
11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Cleveland Clinic Martin North Hospital

Acute Care Hospitals · Stuart, FL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100044
Location200 SE Hospital AveStuart, FL 34994 · Martin County
Emergency services Birthing friendly

Hca Florida Lawnwood Hospital

Acute Care Hospitals · Fort Pierce, FL
1/5 CMS rating
OwnershipProprietary
CMS Certification Number100246
Location1700 S 23rd StFort Pierce, FL 34950 · St. Lucie 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.

Reported Quality Measures

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.
77%368 patients3/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
99%736 patients5/55-star benchmark: 99%
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…
87%736 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
0%736 patients1/55-star benchmark: 59%
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.

Other Providers at the Same Location NPPES

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

TAKASHI KOYAMA DMD PHD PA
Oral & Maxillofacial Surgery
2402 FRIST BLVD STE 100
FORT PIERCE, FL 34950
St. Lucie County (772) 461-9700

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 Takashi Koyama's NPI number?

The NPI number for Takashi Koyama is 1356459028. It was assigned to this individual provider in the NPPES registry on August 25, 2006.

Where is Takashi Koyama located?

Takashi Koyama practices at 2402 Frist Blvd Ste 100, Fort Pierce, FL 34950. The listed phone number is (772) 461-9700.

What is Takashi Koyama's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Takashi Koyama enrolled in Medicare?

Yes. Takashi Koyama 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 Takashi Koyama's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Takashi Koyama reassigns Medicare benefits to Takashi Koyama Dmd Phd PA (Fort Pierce, FL). 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 Takashi Koyama's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Takashi Koyama accept?

Health plans from Ambetter Health, Ambetter of Alabama, Anthem Blue Cross and Blue Shield, BEST Life and Blue Cross and Blue Shield of Montana and 14 other insurers list Takashi Koyama 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.

Is Takashi Koyama affiliated with any hospitals?

According to CMS data, Takashi Koyama is affiliated with Cleveland Clinic Martin North Hospital and Hca Florida Lawnwood Hospital.

When was this NPI record last updated?

The NPPES record for Takashi Koyama was last updated on July 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.