DR. DEREK KOLLER M.D.
NPI 1629338470
Family Medicine in Salem, OR

Q: What is Derek Koller's NPI number?

The NPI number for Derek Koller is 1629338470. It was assigned to this individual provider in the NPPES registry on May 25, 2012.

Q: What is Derek Koller's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Derek Koller was last updated on January 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since May 25, 2012PECOS EnrolledAccepts Medicare Assignment

6861 LEMONGRASS LOOP SE, SALEM, OR 97306(361) 902-4789(361) 902-4588 Get Directions Write a Review

NPPES record last updated: January 13, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Derek Koller M.d. NPPES

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

DR. DEREK KOLLER M.D. (NPI 1629338470) is an individual family medicine provider in Salem, Oregon, licensed in Hawaii (17981) and active in the NPI registry since May 2012. He is enrolled in Medicare PECOS and is a graduate of University Of Texas Medical School At San Antonio (2012).

NPPES Registry Identity

NPI1629338470

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. DEREK KOLLERCredential: M.D.

Location Address6861 LEMONGRASS LOOP SESalem, OR 97306-1474

Mailing Address6861 Lemongrass Loop SeSalem, OR 97306-1474 · (361) 902-4789 · Fax (361) 902-4588

Phone(361) 902-4789

Fax(361) 902-4588

Sole ProprietorYes

Medical School CMSUniversity Of Texas Medical School At San AntonioGraduated 2012

Enumeration DateMay 25, 2012

Last NPPES UpdateJanuary 13, 2020

✔ NPI 1629338470 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in HI · 17981✔ Licensed in IL · 036151000✔ Licensed in FL · ME142837✔ Licensed in TX · S2376✔ Licensed in AZ · 55553✔ Licensed in WY · 11453A✔ Licensed in NV · 17828✔ Licensed in NM · MD2018-0164✔ Licensed in OR · MD186008✔ Licensed in WA · MD60818224✔ Licensed in CO · DR.0059780✔ Licensed in CA · A143337✔ Licensed in MT · MED-PHYS-LIC-60886✔ Licensed in ID · M-14141✔ Licensed in NY · 284778

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

6861 LEMONGRASS LOOP SE, Salem, OR 97306

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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

Dr. Derek Koller M.d. 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 ID941519383

PECOS Enrollment IDI20200401002517

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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

41 services36 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

24 services24 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97306 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

$84.82 typical visit price

range $54.96 – $166.64

Typical copayment $21.20 (range $13.74 – $41.66)

Most-billed visit code 99203

Established Patient

$97.16 typical visit price

range $17.68 – $136.19

Typical copayment $24.29 (range $4.42 – $34.04)

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.

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 Derek Koller's NPI number?

The NPI number for Derek Koller is 1629338470. It was assigned to this individual provider in the NPPES registry on May 25, 2012.

Where is Derek Koller located?

Derek Koller practices at 6861 Lemongrass Loop SE, Salem, OR 97306. The listed phone number is (361) 902-4789.

What is Derek Koller's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Derek Koller enrolled in Medicare?

Yes. Derek Koller 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 Derek Koller was last updated on January 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.