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LASSINA WILL KOIDIMA AGACNP
NPI 1710548771
Nurse Practitioner - Acute Care in Statesboro, GA

Active since June 21, 2019PECOS Enrolled
1635 PONDSIDE DR, STATESBORO, GA 30458(912) 507-9077 Get Directions Write a Review

NPPES record last updated: November 11, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 11, 2021, Jun 21, 2019 (2 updates tracked since 2019).

About Lassina Will Koidima Agacnp NPPES

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

LASSINA WILL KOIDIMA AGACNP (NPI 1710548771) is an individual acute care provider in Statesboro, Georgia, licensed in Georgia (RN220878) and active in the NPI registry since June 2019. He is enrolled in Medicare PECOS and maintains a secondary practice location in Statesboro.

NPPES Registry Identity

NPI1710548771
Entity TypeIndividualMale
Primary Taxonomy363LA2100X
Provider Legal NameLASSINA WILL KOIDIMACredential: AGACNP
Location Address1635 PONDSIDE DRStatesboro, GA 30458-3777
Mailing Address1635 Pondside DrStatesboro, GA 30458-3777 · (912) 507-9077
Phone(912) 507-9077
Sole ProprietorYes
Enumeration DateJune 21, 2019
Last NPPES UpdateNovember 11, 20212 updates tracked since enumeration
NPPES CertifiedNovember 11, 2021
✔ NPI 1710548771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in GA · RN220878
1635 PONDSIDE DR, Statesboro, GA 30458
Open in Google Maps ↗

Secondary Practice Location 1

Location 11499 Fair RdStatesboro, GA 30458-1683 · Phone (912) 486-1000 · Fax (912) 486-1488

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lassina Will Koidima Agacnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

4

Medicare enrollment records show Lassina Koidima reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Statesboro Hma Physician Management LLC
1.4 mi
Hospitalist
1499 FAIR RD
Statesboro, GA 30458
  • Reassigned Medicare billing, Georgia enrollment
  • 47 clinicians in this Medicare group
NPI 1558412023 (912) 871-5437
Effingham Hospital, Inc.
23 mi
Rural Health
3 HIDDEN CREEK DR
Guyton, GA 31312
  • Reassigned Medicare billing, Georgia enrollment
  • 30 clinicians in this Medicare group
NPI 1164651022 (912) 772-8670
Hospital Medicine Services Of Ga LLC
47 mi
Hospitalist
4700 WATERS AVE
Savannah, GA 31404
  • Reassigned Medicare billing, Georgia enrollment
  • 169 clinicians in this Medicare group
NPI 1891653655 (912) 350-7020
Cogent Healthcare Of Georgia PC
117 mi
Internal Medicine
400 CHARTER BLVD
Macon, GA 31210
  • Reassigned Medicare billing, Georgia enrollment
  • 635 clinicians in this Medicare group
NPI 1609827823 (478) 757-8200

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

Areas of Expertise CMS Part B claims 3

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
55 services32 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
37 services37 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
15 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30458 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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 Lassina Koidima's NPI number?

The NPI number for Lassina Koidima is 1710548771. It was assigned to this individual provider in the NPPES registry on June 21, 2019.

Where is Lassina Koidima located?

Lassina Koidima practices at 1635 Pondside Dr, Statesboro, GA 30458. The listed phone number is (912) 507-9077.

What is Lassina Koidima's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Lassina Koidima enrolled in Medicare?

Yes. Lassina Koidima is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Lassina Koidima's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lassina Koidima reassigns Medicare benefits to 4 organizations: Statesboro Hma Physician Management LLC (Statesboro, GA), Effingham Hospital, Inc. (Guyton, GA), Hospital Medicine Services Of Ga LLC (Savannah, GA) and Cogent Healthcare Of Georgia PC (Macon, GA). 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 Lassina Koidima's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Lassina Koidima was last updated on November 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.