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DR. MATT E KOEPKE D.D.S.
NPI 1386909109
Dentist - Oral and Maxillofacial Surgery in Charleston, SC

Active since July 09, 2012PECOS Enrolled
198 RUTLEDGE AVENUE, SUITE 4, CHARLESTON, SC 29403(843) 853-5859(843) 853-5861 Get Directions Write a Review

NPPES record last updated: October 20, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Matt E Koepke D.d.s. NPPES

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

DR. MATT E KOEPKE D.D.S. (NPI 1386909109) is an individual oral and maxillofacial surgery provider in Charleston, South Carolina, licensed in West Virginia (4011) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1386909109
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. MATT E KOEPKECredential: D.D.S.
Location Address198 RUTLEDGE AVENUE, SUITE 4Charleston, SC 29403
Mailing Address198 Rutledge Avenue, Suite 4Charleston, SC 29403 · (843) 853-5859 · Fax (843) 853-5861
Phone(843) 853-5859
Fax(843) 853-5861
Sole ProprietorYes
Enumeration DateJuly 9, 2012
Last NPPES UpdateOctober 20, 2016
✔ NPI 1386909109 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in WV · 4011
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
198 RUTLEDGE AVENUE, Charleston, SC 29403
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Matt E Koepke D.d.s. 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 29403 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
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$67.12 typical visit price
range $16.96 – $133.52
Typical copayment $16.78 (range $4.24 – $33.38)
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.

Other Providers at the Same Location NPPES 2

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

AMANDA POLHEMUS
Nurse Practitioner (Pediatrics)
198 RUTLEDGE AVENUE, SUITE 1
CHARLESTON, SC 29403
Charleston County (843) 723-0855
COLLEEN LEHN DEGEORGE LISW-CP/LCSW
Social Worker (Clinical)
198 RUTLEDGE AVENUE, SUITE 8
CHARLESTON, SC 29403
Charleston County (908) 461-7014

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 Matt Koepke's NPI number?

The NPI number for Matt Koepke is 1386909109. It was assigned to this individual provider in the NPPES registry on July 9, 2012.

Where is Matt Koepke located?

Matt Koepke practices at 198 Rutledge Avenue Suite 4, Charleston, SC 29403. The listed phone number is (843) 853-5859.

What is Matt Koepke's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Matt Koepke enrolled in Medicare?

Yes. Matt Koepke is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Matt Koepke was last updated on October 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.