MEGAN LYNN KOEHLER CNM
NPI 1669986121
Advanced Practice Midwife in Breese, IL

NPI Status: Active since November 20, 2017

Contact Information

9447 HOLY CROSS LN
BREESE, IL
ZIP 62230
Phone: (618) 526-2209
Fax: (618) 526-7372

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  • Individual
  • Female
  • Years of Experience 9
  • Advanced Practice Midwife
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MEGAN KOEHLER

This page provides the complete NPI Profile along with additional information for Megan Koehler, a provider established in Breese, Illinois with a medical specialization in Advanced Practice Midwife and more than 9 years of experience. The healthcare provider is registered in the NPI registry with number 1669986121 assigned on November 2017. The practitioner's primary taxonomy code is 367A00000X with license number 209016720 (IL). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI
1669986121
Provider Name
MEGAN LYNN KOEHLER CNM
Gender
Female
Entity Type
Individual
Location Address
9447 HOLY CROSS LN BREESE, IL 62230
Location Phone
(618) 526-2209
Location Fax
(618) 526-7372
Mailing Address
9447 HOLY CROSS LN BREESE, IL 62230
Mailing Phone
(618) 526-2209
Mailing Fax
(618) 526-7372
Medical School Name
OTHER
Graduation Year
2017
Is Sole Proprietor?
No
Enumeration Date
11-20-2017
Last Update Date
01-19-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Advanced Practice Midwife

Taxonomy Code
367A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
209016720
License State
IL
Taxonomy Description
Advanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling. Source: American College of Nurse-Midwives, www.midwife.org Additional Resources: See the American College of Nurse-Midwives, www.midwife.org, for more information on Certified Nurse-Midwives, Certified Midwives, the American Midwifery Certification Board (AMCB), and licensure.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Essential (No Referrals) - EPO
  • UHC Bronze Standard (No Referrals) - EPO
  • UHC Bronze Standard+ (Dental + Vision, No Referrals) - EPO
  • UHC Gold Advantage ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx, No Referrals) - EPO
  • UHC Gold Standard (No Referrals) - EPO
  • UHC Silver Advantage ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
209016720MEDICAID (05)IL 

Medicare Participation & PECOS Enrollment Status

Megan Koehler is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Megan Koehler is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 4880953512

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20180125001440

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): No

  • Eligible to Order or Refer Power Mobility Devices: No

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $22.11 for a new patient copayment and $17.6 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 62230 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $88.44
  • Minimum New Patient Price $56.28
  • Maximum New Patient Price $173.35
  • Average New Patient Copayment $22.11
  • Minimum New Patient Copayment $14.07
  • Maximum New Patient Copayment $43.33

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $70.42
  • Minimum Established Patient Price $17.51
  • Maximum Established Patient Price $139.99
  • Average Established Patient Copayment $17.6
  • Minimum Established Patient Copayment $4.37
  • Maximum Established Patient Copayment $34.99

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Megan Koehler is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
HSHS HOLY FAMILY HOSPITAL INC200 HEALTH CARE DR
GREENVILLE, IL 62246
(618) 664-1230Acute Care Hospitals
ST JOSEPHS HOSPITAL9515 HOLY CROSS LN
BREESE, IL 62230
(618) 526-4511Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1669986121, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
9
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
8
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
1
Unchanged
Pos 9
2
Doubled → 4
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 9 → 18 → 9 6 → 12 → 3 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 2 + 9 + 1 + 8 + 8 + 1 + 2 + 1 + 4 + 24 = 69

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 69 is 70. The difference is the calculated check digit.

70 - 69 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1669986121.

Other Providers at the Same Location


The following 6 providers are registered at the same or a nearby location.

Obstetrics & Gynecology
9447 HOLY CROSS LN
BREESE, IL 62230
Obstetrics & Gynecology
9447 HOLY CROSS LN
BREESE, IL 62230
Nurse Practitioner (Women's Health)
9447 HOLY CROSS LN
BREESE, IL 62230
Obstetrics & Gynecology
9447 HOLY CROSS LN
BREESE, IL 62230
Obstetrics & Gynecology
9447 HOLY CROSS LN
BREESE, IL 62230
Nurse Practitioner (Women's Health)
9447 HOLY CROSS LN
BREESE, IL 62230

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1669986121, enumerated as an "individual" on November 20, 2017.

The provider is located at 9447 HOLY CROSS LN BREESE, IL 62230 and the phone number is (618) 526-2209.

Advanced Practice Midwife with taxonomy code 367A00000X.

The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter Health,. Please consult your insurance carrier or call the provider to verify.

Megan Koehler is affiliated with: HSHS HOLY FAMILY HOSPITAL INC and ST JOSEPHS HOSPITAL.