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DR. SANDHYA V KOPPULA MD
NPI 1962487231
Dermatology in Beaverton, OR

Active since December 09, 2005Opted out of Medicare · through Jan 1, 2028
17200 NW CORRIDOR COURT, SUITE 112, BEAVERTON, OR 97006(503) 439-6969(503) 439-6868 Get Directions Write a Review

NPPES record last updated: November 3, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Sandhya V Koppula Md NPPES

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

DR. SANDHYA V KOPPULA MD (NPI 1962487231) is an individual dermatology provider in Beaverton, Oregon, licensed in Oregon (MD18825) and active in the NPI registry since December 2005. She has opted out of Medicare through January 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1962487231
Entity TypeIndividualFemale
Primary Taxonomy207N00000X
Provider Legal NameDR. SANDHYA V KOPPULACredential: MD
Location Address17200 NW CORRIDOR COURT, SUITE 112Beaverton, OR 97006-3295
Mailing Address17200 Nw Corridor Court, Suite 112Beaverton, OR 97006-3295 · (503) 439-6969 · Fax (503) 439-6868
Phone(503) 439-6969
Fax(503) 439-6868
Sole ProprietorYes
Enumeration DateDecember 9, 2005
Last NPPES UpdateNovember 3, 2010
✔ NPI 1962487231 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in OR · MD18825
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
17200 NW CORRIDOR COURT, Beaverton, OR 97006
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Other Identifiers 4

Medicaid8180424WA
Medicare ID-Type Unspecified0000BLBMROR
Medicare UPING12483
Medicaid075544OR

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Dr. Sandhya V Koppula Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2020 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2020
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97006 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
$73.28 typical visit price
range $19.32 – $144.79
Typical copayment $18.32 (range $4.83 – $36.19)
Most-billed visit code 99213
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 Sandhya Koppula's NPI number?

The NPI number for Sandhya Koppula is 1962487231. It was assigned to this individual provider in the NPPES registry on December 9, 2005.

Where is Sandhya Koppula located?

Sandhya Koppula practices at 17200 NW Corridor Court Suite 112, Beaverton, OR 97006. The listed phone number is (503) 439-6969.

What is Sandhya Koppula's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Sandhya Koppula enrolled in Medicare?

No. Sandhya Koppula has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Sandhya Koppula was last updated on November 3, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.