DR. MICHAEL JR. KOOISTRA (MD) – Family Medicine Physician, NPI 1508864380
Family Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
2,862 FAMILY PRACTICE in IN
Provider Addresses for DR. MICHAEL JR. KOOISTRA (MD)
1306 E 7TH ST STE A
AUBURN, IN 467062537
Phone: (260) 925-1255
Fax: (260) 925-1256
Type: Location
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 468451701
Phone:
Type: Mailing
104 SOUTH WEST ST.
EDGERTON, OH 43517
Phone: (419) 298-2458
Fax: (419) 298-2478
Type: Location
104, West Street, Edgerton, Saint Joseph, Williams County, Ohio, 43517, United States
EDGERTON, OH 43517
Phone: (419) 298-2458
Fax: (419) 298-2478
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 90 Open Payments records for all available years, with a total value of $1,542.
Total Amount is formed as General ($1,542) + Research ($0) + Ownership ($0) = $1,542.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($279).
Total Amount
$1,542
General + Research + Ownership
Payments
90
Total payment records
General Amount
$1,542
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $279 |
| ABBVIE INC. | $251 |
| Lilly USA, LLC | $190 |
| Novo Nordisk Inc | $190 |
| Bayer Healthcare Pharmaceuticals Inc. | $131 |
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: 2007-11-27
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 |
|---|---|---|---|---|
| I20070612000566 | I | Family Practice | IN | TBD |
| I20071127000866 | I | Family Practice | OH | 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 |
|---|---|---|---|---|
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 368 | 103 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 211 | 156 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 77 | 64 | $0 |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 45 | 36 | $0 |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 29 | 15 | $0 |
Insurance plans in this area (ZIP 46706)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IN | |
| Nurse Practitioner | NM | |
| - | IN | |
| Nurse Practitioner | IN | |
| Family Practice | IN | |
| - | IN | |
| - | IN | |
| Infectious Disease | IN | |
| Internal Medicine | IN | |
| - | IN |
Reviews
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