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FLORIDA INSTITUTE OF OMS
NPI 1558429753
Oral & Maxillofacial Surgery in Fort Pierce, FL

Active since December 04, 2006
2402 FRIST BLVD STE 100, FORT PIERCE, FL 34950(772) 461-9700(772) 461-9300 Get Directions Write a Review

NPPES record last updated: January 31, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Florida Institute Of Oms NPPES

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

FLORIDA INSTITUTE OF OMS (NPI 1558429753) is a healthcare organization registered as an oral & maxillofacial surgery in Fort Pierce, Florida and active in the NPI registry since December 2006. The organization lists Tanya Gonzalez, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1558429753
Entity TypeOrganization
Primary Taxonomy204E00000X
Legal Business NameTAKASHI KOYAMA DMD PHD PA
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
Organization SubpartNo
Authorized OfficialTanya GonzalezPractice Manager · (772) 461-9700
Enumeration DateDecember 4, 2006
Last NPPES UpdateJanuary 31, 2024
NPPES CertifiedJanuary 31, 2024
✔ NPI 1558429753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
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
2402 FRIST BLVD STE 100, Fort Pierce, FL 34950
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Other Names 1

Doing Business AsFlorida Institute Of Oms

Other Identifiers 1

OtherDN 16376FL · Medical License

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Florida Institute Of Oms is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Florida Institute Of Oms, which bills Medicare for the services this clinician delivers.

Clinician (1)

Takashi Koyama, DMD, PHD FACS
Oral Surgery
NPI 1356459028
2402 FRIST BLVD STE 100
Fort Pierce, FL 34950
(772) 461-9700
✔ PECOS✔ Accepts MedicareSame address

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

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 Dmd Phd PA's NPI number?

The NPI number for Takashi Koyama Dmd Phd PA is 1558429753. It was assigned to this organization in the NPPES registry on December 4, 2006. The provider is doing business as Florida Institute Of Oms.

Where is Takashi Koyama Dmd Phd PA located?

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

What is Takashi Koyama Dmd Phd PA's specialty?

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

Is Takashi Koyama Dmd Phd PA enrolled in Medicare?

Yes. Takashi Koyama Dmd Phd PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Takashi Koyama Dmd Phd PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Oral Surgery) reassigns their Medicare billing to Takashi Koyama Dmd Phd PA. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Takashi Koyama Dmd Phd PA accept?

Health plans from Ambetter Health, Ambetter of Alabama and UnitedHealthcare list Takashi Koyama Dmd Phd PA 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.

When was this NPI record last updated?

The NPPES record for Takashi Koyama Dmd Phd PA was last updated on January 31, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.