MR. JACK A KOOIENGA APRN
NPI 1518216308
Nurse Practitioner - Acute Care in Wyoming, MI
About Mr. Jack A Kooienga Aprn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. JACK A KOOIENGA APRN (NPI 1518216308) is an individual acute care provider in Wyoming, Michigan, licensed in Florida (APRN11012762) and active in the NPI registry since September 2012. He is enrolled in Medicare PECOS, is affiliated with Adventhealth Lake Wales, and maintains a secondary practice location in Orlando.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Other Identifiers 1
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
Mr. Jack A Kooienga Aprn 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 Reassignments
7Medicare enrollment records show Jack Kooienga reassigns Medicare billing to 7 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Three Rivers, MI 49093
- Reassigned Medicare billing, Michigan enrollment
- 47 clinicians in this Medicare group
Cadillac, MI 49601
- Reassigned Medicare billing, Michigan enrollment
- 123 clinicians in this Medicare group
Milwaukee, WI 53211
- Reassigned Medicare billing, Wisconsin enrollment
- 1,343 clinicians in this Medicare group
Gaylord, MI 49735
- Reassigned Medicare billing, Michigan enrollment
- 62 clinicians in this Medicare group
Charlevoix, MI 49720
- Reassigned Medicare billing, Michigan enrollment
- 73 clinicians in this Medicare group
Orlando, FL 32803
- Reassigned Medicare billing, Florida enrollment
- 3,005 clinicians in this Medicare group
Aventura, FL 33180
- Reassigned Medicare billing, Florida enrollment
- 287 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.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Adventhealth Lake Wales
Acute Care Hospitals · Lake Wales, FLHca Florida Lake City Hospital
Acute Care Hospitals · Lake City, FLMunson Healthcare Cadillac Hospital
Acute Care Hospitals · Cadillac, MIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 49519 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
WYOMING, MI 49519
WYOMING, MI 49519
WYOMING, MI 49519
WYOMING, MI 49519
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 Jack Kooienga's NPI number?
The NPI number for Jack Kooienga is 1518216308. It was assigned to this individual provider in the NPPES registry on September 7, 2012.
Where is Jack Kooienga located?
Jack Kooienga practices at 5900 Byron Center Ave SW, Wyoming, MI 49519. The listed phone number is (616) 252-7200.
What is Jack Kooienga's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.
Is Jack Kooienga enrolled in Medicare?
Yes. Jack Kooienga 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 organizations bill Medicare for Jack Kooienga's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jack Kooienga reassigns Medicare benefits to 7 organizations: Michigan Emergency Physicians, LLP (Three Rivers, MI), Wexford Physician Services PC (Cadillac, MI), Ascension Medical Group-Southeast Wisconsin Inc (Milwaukee, WI), Otsego Physician Services PC (Gaylord, MI), North Michigan Physician Services PC (Charlevoix, MI) and 2 more organizations, listed in the Medicare section above. Each 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 Jack Kooienga's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jack Kooienga accept?
Health plans from Oscar Health Maintenance Organization of Florida and Wellpoint list Jack Kooienga 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 Jack Kooienga affiliated with any hospitals?
According to CMS data, Jack Kooienga is affiliated with Adventhealth Lake Wales, Hca Florida Lake City Hospital and Munson Healthcare Cadillac Hospital.
When was this NPI record last updated?
The NPPES record for Jack Kooienga was last updated on August 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Mr. Jack A Kooienga, APRN · NPI 1518216308
Acute Care physician in Wyoming, Michigan. Individual provider, active in the CMS NPPES registry since September 7, 2012.
## Identity
- **NPI:** 1518216308 (Entity type: Individual)
- **Enumerated:** September 7, 2012
- **Primary specialty:** Nurse Practitioner - Acute Care · taxonomy 363LA2100X
- **State license:** APRN11012762 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 5900 BYRON CENTER AVE SW, Wyoming, MI 49519-9606
- **Phone:** (616) 252-7200 · **Fax:** (616) 252-7830
## 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:** 7 organizations under Medicare reassignment (form CMS-855R): Michigan Emergency Physicians, LLP (NPI 1205075074, Three Rivers, MI); Wexford Physician Services PC (NPI 1649084260, Cadillac, MI); Ascension Medical Group-Southeast Wisconsin Inc (NPI 1194473066, Milwaukee, WI); Otsego Physician Services PC (NPI 1346054236, Gaylord, MI); North Michigan Physician Services PC (NPI 1972314821, Charlevoix, MI); and 2 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2003
## Record status
- **NPPES last updated:** August 9, 2021
- **Other identifiers:** Medicaid 110773300 (FL)
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Source: [NPI Profile](https://npiprofile.com/npi/1518216308) · Data from the CMS NPPES public registry.