ALYSSA NICOLE KOOPAL (PA) – Physician Assistant, NPI 1497221089
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
Provider Addresses for ALYSSA NICOLE KOOPAL (PA)
245 OAKLAND PKWY APT 1807
LEESBURG, GA 317631839
Phone: (310) 650-2839
Type: Mailing
142 PLANTATION DR
LEESBURG, GA 317634284
Phone: (310) 650-2839
Type: Mailing
1712A E BROAD AVE
ALBANY, GA 317052611
Phone: (229) 639-3100
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 21 Open Payments records for all available years, with a total value of $434.
Total Amount is formed as General ($434) + Research ($0) + Ownership ($0) = $434.
Last reported payment date: 2024-06-20 • Largest payer in this snapshot: ViiV Healthcare Company ($154).
Total Amount
$434
General + Research + Ownership
Payments
21
Total payment records
General Amount
$434
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ViiV Healthcare Company | $154 |
| Merck Sharp & Dohme LLC | $63 |
| Janssen Biotech, Inc. | $57 |
| Hologic Sales and Service, LLC | $32 |
| EMD Serono, Inc. | $31 |
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: 2020-01-30
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200130002372 | I | Physician Assistant | GA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 31763)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | TX | |
| - | GA | |
| - | GA | |
| - | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MI | |
| Nurse Practitioner | GA | |
| Certified Nurse Midwife (Cnm) | GA | |
| P O D I A T R Y | CT | |
| Internal Medicine | GA | |
| Nurse Practitioner | GA |
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