KELSEY DIANA KOESTER – Surgical Physician Assistant, NPI 1619673951

KELSEY DIANA KOESTER is a healthcare provider. based in Mountain brk, Alabama. specializing in PHYSICIAN ASSISTANT. They hold a License No. 2119 (AL). The NPI Number for KELSEY DIANA KOESTER is 1619673951

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
KELSEY DIANA KOESTER
NPI
1619673951
Phone
Not provided
Address
3076 OVERTON RD
Enumeration Date
7 February 2023
Last Update Date
7 February 2023

Doctor Profile

Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Secondary Phone
2059330987
Graduation Year
2022 (4 years ago)
PAC ID
4981062726
Group Practice PAC ID
9335043033
Professional Enrollment ID
I20230626003345
Address ID
AL352034050BI1927XNXXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

1,202 PHYSICIAN ASSISTANT in AL

Provider Addresses for KELSEY DIANA KOESTER

  • 3076 OVERTON RD

    MOUNTAIN BRK, AL 352232738

    Phone:

    Type: Mailing

  • 2100 16TH AVE S

    BIRMINGHAM, AL 352055021

    Phone: (205) 933-0987

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 73 Open Payments records for all available years, with a total value of $2,615.

Total Amount is formed as General ($2,615) + Research ($0) + Ownership ($0) = $2,615.

Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Dermavant Sciences, Inc. ($555).

Total Amount

$2,615

General + Research + Ownership

Payments

73

Total payment records

General Amount

$2,615

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-06-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230626003345IPhysician AssistantALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35223)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9335043033View full group profile
NameSpecialtyState
Internal MedicineAL
Micrographic Dermatologic Surgery (Mds), DermatologyAL
Physician AssistantAL
Physician AssistantAL
D E R M A T O L O G YAL
D E R M A T O L O G YAL
Physician AssistantAL
D E R M A T O L O G YAL
D E R M A T O L O G YAL
D E R M A T O L O G YAL

Reviews

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Frequently asked questions

What is the registry number for KELSEY DIANA KOESTER?
The registry entry for KELSEY DIANA KOESTER shows NPI 1619673951.
Is KELSEY DIANA KOESTER currently accepting referrals based on NPI status?
Registry metadata lists KELSEY DIANA KOESTER as active.
Which specialty label fits KELSEY DIANA KOESTER?
NPPES ties KELSEY DIANA KOESTER to Surgical Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit KELSEY DIANA KOESTER in Mountain Brk, Alabama?
For routing, start with Mountain Brk, Alabama for KELSEY DIANA KOESTER, then verify phone and hours locally.
Why is information missing for KELSEY DIANA KOESTER?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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