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JESSE R KOOISTRA FNP
NPI 1467251496
Nurse Practitioner - Family in Warsaw, IN

Active since March 11, 2025PECOS EnrolledAccepts Medicare Assignment
1500 PROVIDENT DR STE A, WARSAW, IN 46580(574) 372-7637 Get Directions Write a Review

NPPES record last updated: July 18, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jesse R Kooistra Fnp NPPES

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

JESSE R KOOISTRA FNP (NPI 1467251496) is an individual family provider in Warsaw, Indiana, licensed in Indiana (71016732A) and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1467251496
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameJESSE R KOOISTRACredential: FNP
Location Address1500 PROVIDENT DR STE AWarsaw, IN 46580-3297
Mailing Address6920 Pointe Inverness Way Ste 200Fort Wayne, IN 46804-7934 · (260) 479-3513
Phone(574) 372-7637
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateMarch 11, 2025
Last NPPES UpdateJuly 18, 2025
NPPES CertifiedJuly 18, 2025
✔ NPI 1467251496 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in IN · 71016732A✔ Licensed in IN · E3105472
Also ListedEmergency Medical Technician, BasicTaxonomy 146N00000X
Also ListedRegistered Nurse · EmergencyTaxonomy 163WE0003X · License E3105472 (IN)
1500 PROVIDENT DR STE A, Warsaw, IN 46580
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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 and accepts Medicare assignment

Jesse R Kooistra Fnp 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 ID4587178892
PECOS Enrollment IDI20250709001694
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 46580 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
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 6

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

ANITA LYNN ALCORN FNP
Nurse Practitioner (Family)
1500 PROVIDENT DR STE A
WARSAW, IN 46580
Kosciusko County (574) 372-7637
LORI A YOUNG NP
Nurse Practitioner (Family)
1500 PROVIDENT DR STE A
WARSAW, IN 46580
Kosciusko County (574) 372-7637
CARMEN JOHNSTON PA
Physician Assistant
1500 PROVIDENT DR STE A
WARSAW, IN 46580
Kosciusko County (574) 372-7637
MEDSTAT LLC
Clinic/Center (Primary Care)
1500 PROVIDENT DR STE A
WARSAW, IN 46580
Kosciusko County (574) 372-7637
SCOTT HARLAN EHMEN MD
Family Medicine
1500 PROVIDENT DR STE A
WARSAW, IN 46580
Kosciusko County (574) 372-7637
AMIE L ROBERTS FNP-C
Nurse Practitioner (Family)
1500 PROVIDENT DR STE A
WARSAW, IN 46580
Kosciusko County (574) 372-7637

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 Jesse Kooistra's NPI number?

The NPI number for Jesse Kooistra is 1467251496. It was assigned to this individual provider in the NPPES registry on March 11, 2025.

Where is Jesse Kooistra located?

Jesse Kooistra practices at 1500 Provident Dr Ste A, Warsaw, IN 46580. The listed phone number is (574) 372-7637.

What is Jesse Kooistra's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jesse Kooistra enrolled in Medicare?

Yes. Jesse Kooistra 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.

When was this NPI record last updated?

The NPPES record for Jesse Kooistra was last updated on July 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.