KODJOVI DINYEFAN KODJO (MD) – Psychiatry Physician, NPI 1780100958
Psychiatry Physician
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Profile Insights
NPPES metrics only — not quality of care.
3,075 FAMILY PRACTICE in MN
Provider Addresses for KODJOVI DINYEFAN KODJO (MD)
4050 Coon Rapids Blvd NW
Coon Rapids, MN 554332522
Phone: (612) 262-1220
Type: Location
2000 Brookside Dr
Kingsport, TN 376604627
Phone: (423) 857-7000
Type: Location
1519 Main St
Sneedville, TN 378693657
Phone: (423) 733-5000
Type: Location
1420 Tusculum Blvd
Greeneville, TN 377454279
Phone: (423) 787-5000
Type: Location
1901 S Shady St
Mountain City, TN 376832021
Phone: (423) 727-1100
Type: Location
245 Medical Park Dr
Marion, VA 243541100
Phone: (276) 378-1000
Type: Location
58 Carroll Street
Lebanon, VA 242664510
Phone: (276) 883-8000
Type: Location
312 Hospital Dr
Clintwood, VA 242286786
Phone: (276) 926-0300
Type: Location
300 Med Tech Pkwy
Johnson City, TN 376042277
Phone: (423) 302-1000
Type: Location
3333 Riverbend Dr
Springfield, OR 974778800
Phone: (541) 222-2185
Fax: (541) 222-2195
Type: Location
1515 Village Dr
Cottage Grove, OR 974249700
Phone: (458) 205-6555
Fax: (458) 205-6570
Type: Location
1990 Holton Ave E
Big Stone Gap, VA 242193350
Phone: (276) 523-3111
Type: Location
1 Medical Park Blvd
Bristol, TN 376207430
Phone: (423) 844-1121
Type: Location
400 N State Of Franklin Rd
Johnson City, TN 376046035
Phone: (423) 431-6111
Type: Location
11600 W 2nd Pl
Lakewood, CO 802281527
Phone: (720) 321-0000
Fax: (720) 321-4165
Type: Location
1501 W Elk Ave
Elizabethton, TN 376432874
Phone: (423) 542-1300
Type: Location
2030 Temple Hill Rd
Erwin, TN 376508721
Phone: (423) 743-3141
Type: Location
130 W Ravine Rd
Kingsport, TN 376603837
Phone: (423) 224-4000
Type: Location
3100 Tongass Ave
Ketchikan, AK 999015746
Phone: (907) 228-7660
Fax: (907) 228-8140
Type: Location
16000 Johnston Memorial Dr
Abingdon, VA 242117664
Phone: (276) 258-1000
Type: Location
2017 Jefferson St SW
Roanoke, VA 240142419
Phone: (540) 981-8025
Type: Location
915 HIGHLAND BLVD
BOZEMAN, MT 597156902
Phone: (406) 414-5000
Type: Location
400 9th St
Florence, OR 974397398
Phone: (458) 205-6555
Fax: (458) 205-6577
Type: Location
1500 Commonwealth Ave
Williamsburg, VA 231855229
Phone: (757) 585-2250
Fax: (757) 903-2285
Type: Location
1020 First Colonial Rd Ste A
Virginia Beach, VA 234543078
Phone: (757) 395-1850
Type: Location
851 Locust St
Rogersville, TN 378572407
Phone: (423) 921-7000
Type: Location
Interfaith Medical Center, 1545, Atlantic Avenue, Bedford-Stuyvesant, Brooklyn, Kings County, New York, 11213, United States
BROOKLYN, NY 112131122
Phone: (718) 613-4000
Type: Location
1906, Belleview Avenue Southeast, Bellview Terrace, Roanoke, Roanoke (city), Virginia, 24014, United States
ROANOKE, VA 240141838
Phone:
Type: Mailing
1906 BELLEVIEW AVE SE
ROANOKE, VA 240141838
Phone: (240) 319-0421
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2026-01-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 23 Medicare enrollment records; no due dates published yet.
Enrollment records
23
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 |
|---|---|---|---|---|
| I20211227000984 | I | Psychiatry | VA | TBD |
| I20220108000059 | I | Psychiatry | FL | TBD |
| I20220622000294 | I | Psychiatry | GA | TBD |
| I20220912000739 | I | Psychiatry | NC | TBD |
| I20221122000276 | I | Psychiatry | TN | TBD |
| I20230202000589 | I | Psychiatry | NJ | TBD |
| I20230314002808 | I | Psychiatry | MI | TBD |
| I20230512002064 | I | Family Practice | MN | TBD |
| I20230607001792 | I | Psychiatry | OR | TBD |
| I20230607003296 | I | Psychiatry | WA | TBD |
| I20230615000284 | I | Psychiatry | MO | TBD |
| I20230728001099 | I | Psychiatry | PA | TBD |
| I20240306003543 | I | Psychiatry | MT | TBD |
| I20240401002782 | I | Psychiatry | WV | TBD |
| I20240621000966 | I | Psychiatry | WY | TBD |
| I20240715002325 | I | Psychiatry | AK | TBD |
| I20241101000722 | I | Psychiatry | NY | TBD |
| I20241115000464 | I | Psychiatry | CO | TBD |
| I20250128002440 | I | Psychiatry | WI | TBD |
| I20250625003672 | I | Psychiatry | ND | TBD |
| I20250808000642 | I | Psychiatry | TX | TBD |
| I20251106005067 | I | Psychiatry | CA | TBD |
| I20260105000228 | I | Psychiatry | UT | 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 |
|---|---|---|---|---|
| 90792 | Psychiatric diagnostic evaluation with medical services | 170 | 167 | $0 |
| G0425 | Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth | 49 | 48 | $0 |
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 45 | 36 | $0 |
| G0406 | Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth | 41 | 31 | $0 |
| G0426 | Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth | 34 | 34 | $0 |
Insurance plans in this area (ZIP 55433)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | NY | |
| Physician Assistant | NY | |
| Radiation Oncology, Hematology/Oncology | NY | |
| - | NY | |
| P A T H O L O G Y | NY | |
| Hospice/Palliative Care | WI | |
| Hospitalist, Internal Medicine | PA | |
| Hospitalist, Internal Medicine | NY | |
| - | NY | |
| Critical Care (Intensivists), Internal Medicine, Pulmonary Disease | WV |
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