LAUREL KATHERINE HALLOCK KOPPELMAN FNP-C
NPI 1942623764
Nurse Practitioner - Family in Portland, OR

Active since January 30, 2014PECOS EnrolledAccepts Medicare Assignment
97.83/100
CMS Quality Rating
12720 SE DIVISION STREET, PORTLAND, OR 97236(503) 988-3601 Get Directions Write a Review

NPPES record last updated: April 23, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Laurel Katherine Hallock Koppelman Fnp-c NPPES

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

LAUREL KATHERINE HALLOCK KOPPELMAN FNP-C (NPI 1942623764) is an individual family provider in Portland, Oregon, licensed in Oregon (201392556) and active in the NPI registry since January 2014. She is enrolled in Medicare PECOS and is a graduate of Oregon Health Sciences University School Of Medicine (2013).

NPPES Registry Identity

NPI1942623764
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameLAUREL KATHERINE HALLOCK KOPPELMANCredential: FNP-C
Location Address12720 SE DIVISION STREETPortland, OR 97236
Mailing Address421 Sw Oak St, Ste. 210Portland, OR 97204-1817 · (503) 988-7468 · Fax (503) 988-3015
Sole ProprietorNo
Medical School CMSOregon Health Sciences University School Of MedicineGraduated 2013
Enumeration DateJanuary 30, 2014
Last NPPES UpdateApril 23, 2014
NPI 1942623764 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in OR · 201392556
12720 SE DIVISION STREET, Portland, OR 97236

Other Identifiers 3

Medicaid096511OR
Medicare OSCAR/certificationR0000WCJHTOR
Medicaid22959OR

Accepted Insurance

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

Laurel Katherine Hallock Koppelman Fnp-c 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 ID5395960033
PECOS Enrollment IDI20140714000426
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97236 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
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$103.51 typical visit price
range $19.32 – $144.79
Typical copayment $25.87 (range $4.83 – $36.19)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.83/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.97
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
1 supplier12 claims319 services$4.85 avg. paid by Medicare
Enteral nutrition infusion pump, any type B9002
Other-Enteral and Parenteral · category OB005N
1 supplier12 claims12 services$52.34 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
1 supplier11 claims11 services$11.65 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Laurel Hallock Koppelman's NPI number?

The NPI number for Laurel Hallock Koppelman is 1942623764. It was assigned to this individual provider in the NPPES registry on January 30, 2014.

Where is Laurel Hallock Koppelman located?

Laurel Hallock Koppelman practices at 12720 SE Division Street, Portland, OR 97236. The listed phone number is (503) 988-3601.

What is Laurel Hallock Koppelman's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Laurel Hallock Koppelman enrolled in Medicare?

Yes. Laurel Hallock Koppelman 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.

What insurance does Laurel Hallock Koppelman accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and Regence BlueCross BlueShield of Oregon list Laurel Hallock Koppelman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Laurel Hallock Koppelman was last updated on April 23, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.