DR. BRANDON KOUPAL (OD) – Optometrist, NPI 1194403774

DR. BRANDON KOUPAL (OD) is a healthcare provider. based in Lakeville, Minnesota. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 3874 (MN). The NPI Number for DR. BRANDON KOUPAL (OD) is 1194403774

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
DR. BRANDON KOUPAL (OD)
NPI
1194403774
Phone
(952) 898-9588
Address
17690 Kenwood Trl
Enumeration Date
5 July 2023
Last Update Date
19 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9528989588
Graduation Year
2023 (3 years ago)
PAC ID
9830550219
Group Practice PAC ID
9032265871
Professional Enrollment ID
I20230801003837
Address ID
MN550449764LA17690TRLX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

879 OPTOMETRY in MN

Provider Addresses for DR. BRANDON KOUPAL (OD)

  • 17690 Kenwood Trl

    Lakeville, MN 550449764

    Phone: (952) 898-9588

    Type: Location

  • 8300 COMMONWEALTH DRIVE

    APT 334

    EDEN PRAIRIE, MN 55344

    Phone: (605) 261-6327

    Type: Mailing

  • 1004 COUNTY ROAD 42 E

    BURNSVILLE, MN 553374652

    Phone: (952) 894-1400

    Type: Location

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 $68.

Total Amount is formed as General ($68) + Research ($0) + Ownership ($0) = $68.

Last reported payment date: 2024-10-16 • Largest payer in this snapshot: CooperVision Inc. ($68).

Total Amount

$68

General + Research + Ownership

Payments

4

Total payment records

General Amount

$68

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-16

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
CooperVision Inc.$68
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: 2023-08-01

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
I20230801003837IOptometryMNTBD

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
92014Established patient complete exam of visual system1919$0
View full utilization report →

Insurance plans in this area (ZIP 55044)

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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: 9032265871View full group profile
NameSpecialtyState
O P T O M E T R YMN
O P T O M E T R YMN

Reviews

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Frequently asked questions

What unique ID ties claims to DR. BRANDON KOUPAL (OD)?
NPI 1194403774 is assigned to DR. BRANDON KOUPAL (OD) under the national enumeration system.
Is DR. BRANDON KOUPAL (OD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize DR. BRANDON KOUPAL (OD)'s specialty in plain language?
Clinically, the directory lists DR. BRANDON KOUPAL (OD) with Optometrist. Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. BRANDON KOUPAL (OD)?
The page summarizes Lakeville, Minnesota for DR. BRANDON KOUPAL (OD); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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