ANNA LIESE KOOI – Family Medicine Physician, NPI 1255999751

ANNA LIESE KOOI is a healthcare provider. based in Fruitport, Michigan. specializing in FAMILY PRACTICE. They hold a License No. 5151013946 (MI). The NPI Number for ANNA LIESE KOOI is 1255999751

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
ANNA LIESE KOOI
NPI
1255999751
Phone
(231) 672-2900
Address
3443 Farr Rd
Enumeration Date
31 May 2019
Last Update Date
27 June 2025

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
6162130253
Graduation Year
2019 (7 years ago)
PAC ID
8123403102
Group Practice PAC ID
2466881990
Professional Enrollment ID
I20220912001027
Address ID
MI494172795GR16986RDXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness85
Years active:7State licenses:1Digital endpointsOther names

4,418 FAMILY PRACTICE in MI

Provider Addresses for ANNA LIESE KOOI

  • 3443 Farr Rd

    Fruitport, MI 494158779

    Phone: (231) 672-2900

    Type: Location

  • 2700 Baker St Fl 3

    Muskegon, MI 494442157

    Phone: (317) 371-3352

    Fax: (231) 737-1335

    Type: Location

  • Leahy Street, Muskegon, Muskegon County, Michigan, 49444, United States

    MUSKEGON, MI 494425543

    Phone: (231) 727-5209

    Type: Mailing

  • 3443, Farr Road, Fruitport Charter Township, Muskegon County, Michigan, 49415, United States

    FRUITPORT, MI 494158779

    Phone: (231) 672-2900

    Type: Location

  • 11 TRAFALGAR SQ

    TRAFALGAR, IN 461819515

    Phone: (317) 680-9103

    Fax: (317) 878-2355

    Type: Mailing

  • 5550 S EAST ST STE C

    INDIANAPOLIS, IN 462271991

    Phone: (317) 534-4660

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 26 Open Payments records for all available years, with a total value of $604.

Total Amount is formed as General ($604) + Research ($0) + Ownership ($0) = $604.

Last reported payment date: 2024-12-06 • Largest payer in this snapshot: Novo Nordisk Inc ($251).

Total Amount

$604

General + Research + Ownership

Payments

26

Total payment records

General Amount

$604

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-06

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: 2022-09-12

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220912001027IFamily PracticeMITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49415)

Loading plans...

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: 2466881990View full group profile
NameSpecialtyState
-MI
Physician AssistantMI
Nurse PractitionerMI
Family PracticeMI

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What federal number belongs to ANNA LIESE KOOI?
The federal identifier for ANNA LIESE KOOI is NPI 1255999751.
Does this profile mean ANNA LIESE KOOI is currently active?
Yes — ANNA LIESE KOOI appears active in the national provider directory.
Does ANNA LIESE KOOI list a primary specialty?
If you are matching referrals, note Family Medicine Physician for ANNA LIESE KOOI. Clinical services aligned with this taxonomy classification.
Does ANNA LIESE KOOI practice in Michigan?
You will see Fruitport, Michigan on file for ANNA LIESE KOOI alongside any extra practice locations.
What if Fruitport, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

Similar Providers

MR. DAVID LEON DORA (D.O.)

Family Medicine Physician
PO BOX 1848
NPI: 1629079686

CHAD UPTIGROVE (DO)

Family Medicine Physician
1223, Mercy Drive, Muskegon, Muskegon County, Michigan, 49444, United States
NPI: 1851378657

DR. KRISTEN KAY WOODS (MD)

Family Medicine Physician
US Post Office - North Muskegon, 404, Center Street, North Muskegon, Muskegon County, Michigan, 49445, United States
NPI: 1093792855

ANTHONY V IZOKAITIS (DO)

Family Medicine Physician
3443, Farr Road, Fruitport Charter Township, Muskegon County, Michigan, 49415, United States
NPI: 1699752477

DIANE L PARRETT (DO)

Family Medicine Physician
14 N 3rd Ave
NPI: 1952388563

Unknown Individual

Family Medicine Physician
US Post Office - North Muskegon, 404, Center Street, North Muskegon, Muskegon County, Michigan, 49445, United States
NPI: 1861479552

DARRELL S ROELANDT (DO)

Family Medicine Physician
US Post Office - North Muskegon, 404, Center Street, North Muskegon, Muskegon County, Michigan, 49445, United States
NPI: 1326028028

Mercy General Physician Network

Family Medicine Physician
1310 Wisconsin St Ste 301
NPI: 1023056744

THIRD AVENUE FAMILY CLINIC, PC

Family Medicine Physician
14 N. THIRD AVE
NPI: 1619997996