DR. DAVID J KOUBA (MD) – Dermatology Physician, NPI 1073561866

DR. DAVID J KOUBA (MD) is a healthcare provider. based in South lyon, Michigan. specializing in DERMATOLOGY. They hold the professional credentials MD. They hold a License No. 35089766 (OH). The NPI Number for DR. DAVID J KOUBA (MD) is 1073561866

Main info

Male
26 Years Of Experience
Accepts Medicare Assignment
Name
DR. DAVID J KOUBA (MD)
NPI
1073561866
Phone
(947) 348-1176
Address
106 S Lafayette St
Enumeration Date
4 May 2006
Last Update Date
5 December 2025

Doctor Profile

Medical School Name
JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Secondary Phone
4197854660
Graduation Year
2000 (26 years ago)
PAC ID
3173512233
Group Practice PAC ID
8426585142
Professional Enrollment ID
I20080303000092
Address ID
OH435122605DE417XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Digital endpointsOther names

532 DERMATOLOGY in MI

Provider Addresses for DR. DAVID J KOUBA (MD)

  • 106 S Lafayette St

    South Lyon, MI 481781404

    Phone: (947) 348-1176

    Type: Location

  • 1100 W Main St

    Woodville, OH 434699723

    Phone: (419) 724-5820

    Type: Location

  • 7301 Secor Rd

    Lambertville, MI 481449737

    Phone: (419) 479-5795

    Type: Location

  • 1070 N Shoop Ave

    Wauseon, OH 435671821

    Phone: (419) 330-5200

    Type: Location

  • 341 Trenton Ave

    Findlay, OH 458403745

    Phone: (567) 250-8212

    Type: Location

  • 1136 Country Club Rd Unit C

    Adrian, MI 492218209

    Phone: (517) 366-5110

    Type: Location

  • 675 Cooper St

    Monroe, MI 481611676

    Phone: (419) 479-5791

    Fax: (734) 568-6352

    Type: Location

  • 417 4th St

    Defiance, OH 435122605

    Phone: (419) 785-4660

    Type: Location

  • 1090 N SHOOP AVE

    WAUSEON, OH 435671821

    Phone: (419) 330-5200

    Type: Location

  • 4235, Secor Road, Deaveaux, Toledo, Lucas County, Ohio, 43623, United States

    TOLEDO, OH 43623

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $82.

Total Amount is formed as General ($82) + Research ($0) + Ownership ($0) = $82.

Last reported payment date: 2024-12-05 • Largest payer in this snapshot: Kyowa Kirin, Inc. ($44).

Total Amount

$82

General + Research + Ownership

Payments

4

Total payment records

General Amount

$82

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-05

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: 2008-03-03

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070823000469IDermatologyMITBD
I20080303000092IDermatologyOHTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
88305Pathology examination of tissue using a microscope, intermediate complexity4,9271,942$0
17312Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks1,266686$0
17311Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks1,246830$0
96910Therapy procedure using ultraviolet radiation with tar or petroleum jelly application1,05339$0
Q4158Kerecis omega3, per square centimeter94835$0
View full utilization report →

Insurance plans in this area (ZIP 48178)

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Provider's Procedures

DR. DAVID J KOUBA (MD) performs procedures in DERMATOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYOH11101Biopsy of each additional growth of skin and/or tissue9456
DERMATOLOGYOH13132Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet222197
DERMATOLOGYOH88312Special stained specimen slides to identify organisms including interpretation and report2524

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: 8426585142View full group profile
NameSpecialtyState
Nurse PractitionerMI
Physician AssistantOH
Nurse PractitionerOH
Nurse PractitionerOH
Physician AssistantOH
Physician AssistantOH
D E R M A T O L O G YGA
Nurse PractitionerMI
Dermatology, Micrographic Dermatologic Surgery (Mds)OH

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. DAVID J KOUBA (MD)?
DR. DAVID J KOUBA (MD) — NPI 1073561866 — is the standard way to identify this listing.
Can I rely on DR. DAVID J KOUBA (MD) being an active provider?
As of the registry snapshot, DR. DAVID J KOUBA (MD) is marked active.
What is DR. DAVID J KOUBA (MD) best known for clinically?
Directory data describes DR. DAVID J KOUBA (MD) with Dermatology Physician. Clinical services aligned with this taxonomy classification.
Does DR. DAVID J KOUBA (MD) list a practice location?
Patients near South Lyon, Michigan may find DR. DAVID J KOUBA (MD) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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