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

Active since June 21, 2019PECOS EnrolledAccepts Medicare Assignment
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: August 30, 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, is affiliated with East Georgia Regional Medical Center, 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
Medical School CMSUniversity Of South Alabama College Of MedicineGraduated 2019
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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lassina Will Koidima Agacnp 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 ID8426481458
PECOS Enrollment IDI20191205002127
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 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

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

East Georgia Regional Medical Center

Acute Care Hospitals · Statesboro, GA
3/5 CMS rating
OwnershipProprietary
CMS Certification Number110075
Location1499 Fair RoadStatesboro, GA 30458 · Bulloch County
Emergency services

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 system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Lassina Koidima affiliated with any hospitals?

According to CMS data, Lassina Koidima is affiliated with East Georgia Regional Medical Center.

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.