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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

TEGAN KOSKI MD
NPI 1780323907
General Practice in Apo, AA

Active since June 04, 2022PECOS Enrolled
5502 MARVIN SHIELDS BLVD, BLDG 472, APO, AA 39503(228) 822-5409 Get Directions Write a Review

NPPES record last updated: July 28, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jul 28, 2026, Nov 3, 2025, May 17, 2024 (3 updates tracked since 2024).

About Tegan Koski Md NPPES

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

TEGAN KOSKI MD (NPI 1780323907) is an individual general practice provider in Apo, AA, licensed in South Carolina (MD91062) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780323907
Entity TypeIndividualFemale
Primary Taxonomy208D00000X
Provider Legal NameTEGAN KOSKICredential: MD
Location Address5502 MARVIN SHIELDS BLVD, BLDG 472Apo, AA 39503
Mailing Address5502 Marvin Shields Blvd, Bldg 472Gulfport, MS 39503 · (228) 822-5409
Phone(228) 822-5409
Sole ProprietorNo
Enumeration DateJune 4, 2022
Last NPPES UpdateJuly 28, 20263 updates tracked since enumeration
NPPES CertifiedJuly 28, 2026
✔ NPI 1780323907 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in SC · MD91062
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
5502 MARVIN SHIELDS BLVD, Apo, AA 39503
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Other Names 1

Former Name (1)Tegan Noonan

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tegan Koski Md 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.

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 Tegan Koski's NPI number?

The NPI number for Tegan Koski is 1780323907. It was assigned to this individual provider in the NPPES registry on June 4, 2022. The provider is also known as Tegan Noonan.

Where is Tegan Koski located?

Tegan Koski practices at 5502 Marvin Shields Blvd Bldg 472, Apo, AA 39503. The listed phone number is (228) 822-5409.

What is Tegan Koski's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Tegan Koski enrolled in Medicare?

Yes. Tegan Koski is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tegan Koski was last updated on July 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 29 days 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.