KYLIE MARIE COOPER (M.D.) – Maternal & Fetal Medicine Physician, NPI 1043509730
Maternal & Fetal Medicine Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
201 OBSTETRICS/GYNECOLOGY in ID
Provider Addresses for KYLIE MARIE COOPER (M.D.)
333 N 1st St Ste 150
Boise, ID 837026135
Phone: (208) 381-3088
Type: Location
111 COLCHESTER AVE
SMITH 415 MAILSTOP 251SM4
BURLINGTON, VT 054011473
Phone: (802) 847-4736
Fax: (802) 847-5626
Type: Mailing
333 N 1ST ST STE 150
BOISE, ID 837026135
Phone: (208) 381-3088
Type: Location
200 1ST ST SW
ROCHESTER, MN 559050001
Phone: (507) 284-2511
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $30.
Total Amount is formed as General ($30) + Research ($0) + Ownership ($0) = $30.
Last reported payment date: 2023-03-15 • Largest payer in this snapshot: Medicines360 ($30).
Total Amount
$30
General + Research + Ownership
Payments
1
Total payment records
General Amount
$30
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medicines360 | $30 |
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: 2023-03-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20180621002424 | I | Obstetrics/Gynecology | ID | TBD |
| I20230307002379 | I | Obstetrics/Gynecology | MN | 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 83702)
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Group practice members
- 1
- 2
- 3
- 4
| Name | Specialty | State |
|---|---|---|
| - | WA | |
| Psychiatry, Addiction Medicine | MN | |
| - | MN | |
| - | MN | |
| - | MN | |
| - | MN | |
| O P H T H A L M O L O G Y | MN | |
| - | MN | |
| - | MN | |
| - | MN |
Reviews
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