MR. JACK A KOOIENGA (APRN) – Acute Care Nurse Practitioner, NPI 1518216308
Acute Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,243 NURSE PRACTITIONER in FL
Provider Addresses for MR. JACK A KOOIENGA (APRN)
601 E Rollins St
Orlando, FL 328031248
Phone: (407) 303-7283
Fax: (407) 303-0347
Type: Location
985 GEZON PKWY SW
WYOMING, MI 495099563
Phone: (616) 252-4655
Fax: (616) 252-0103
Type: Mailing
5900 BYRON CENTER AVE SW
WYOMING, MI 495199606
Phone: (616) 252-7200
Fax: (616) 252-7830
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2023-01-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130212000423 | I | Nurse Practitioner | MI | TBD |
| I20210602003183 | I | Nurse Practitioner | FL | TBD |
| I20230123001568 | I | Nurse Practitioner | WI | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99291 | Critical care, first 30-74 minutes | 23 | 22 | $0 |
Insurance plans in this area (ZIP 32803)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | VT | |
| Internal Medicine | NY | |
| Pulmonary Disease, Internal Medicine | OK | |
| - | SC | |
| - | VA | |
| Pulmonary Disease, Critical Care (Intensivists) | GA | |
| Internal Medicine, Critical Care (Intensivists) | OR | |
| - | FL | |
| Internal Medicine | FL | |
| - | TN |
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