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MR. JACK A KOOIENGA APRN
NPI 1518216308
Nurse Practitioner - Acute Care in Wyoming, MI

Active since September 07, 2012PECOS EnrolledAccepts Medicare Assignment
78.01/100
CMS Quality Rating
5900 BYRON CENTER AVE SW, WYOMING, MI 49519(616) 252-7200(616) 252-7830 Get Directions Write a Review

NPPES record last updated: August 9, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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 is a graduate of Other (2003).

NPPES Registry Identity

NPI1518216308
Entity TypeIndividualMale
Primary Taxonomy363LA2100X
Provider Legal NameMR. JACK A KOOIENGACredential: APRN
Location Address5900 BYRON CENTER AVE SWWyoming, MI 49519-9606
Mailing Address985 Gezon Pkwy SwWyoming, MI 49509-9563 · (616) 252-4655 · Fax (616) 252-0103
Phone(616) 252-7200
Fax(616) 252-7830
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateSeptember 7, 2012
Last NPPES UpdateAugust 9, 2021
NPPES CertifiedAugust 9, 2021
✔ NPI 1518216308 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in FL · APRN11012762
Also ListedNurse Practitioner · Critical Care MedicineTaxonomy 363LC0200X · License 4704218318 (MI)
5900 BYRON CENTER AVE SW, Wyoming, MI 49519
Open in Google Maps ↗

Other Identifiers 1

Medicaid110773300FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Wellpoint.Insurance ›

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

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.

PECOS PAC ID6406000876
PECOS Enrollment IDI20130212000423, I20210602003183
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.

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, FL
1/5 CMS rating
OwnershipProprietary
CMS Certification Number100099
Location410 S 11th StLake Wales, FL 33853 · Polk County
Emergency services

Hca Florida Lake City Hospital

Acute Care Hospitals · Lake City, FL
3/5 CMS rating
OwnershipProprietary
CMS Certification Number100156
Location340 NW Commerce DrLake City, FL 32055 · Columbia County
Emergency services

Munson Healthcare Cadillac Hospital

Acute Care Hospitals · Cadillac, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230081
Location400 Hobart StCadillac, MI 49601 · Wexford County
Emergency services Birthing friendly

Physician 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.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

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.

78.01/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality57.51
Promoting Interoperability100
Improvement Activities40
Cost69.18

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.

MATTHEW AARON ERCK DO
Internal Medicine
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7200
AMANDA BRONSON DO
Student in an Organized Health Care Education/Training Program
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7078
GANESH KUMAR DO
Student in an Organized Health Care Education/Training Program
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7200
DR. SARAH PRATT DO
Student in an Organized Health Care Education/Training Program
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7200
SAMANTHA BLAIR PA-C
Physician Assistant
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (812) 909-7200
CASSANDRA PAIGE FRITCH NP
Nurse Practitioner (Family)
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7200
DR. TRISTAN J WORTHINGTON DO
Family Medicine
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7200
MRS. KELLY ANN MURPHY DNP, FNP-C
Nurse Practitioner (Family)
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-3900

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.

What insurance does Jack Kooienga accept?

Health plans from AvMed 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.