KEITH KOPISCH (APRN) – Family Nurse Practitioner, NPI 1124684220

KEITH KOPISCH (APRN) is a healthcare provider. based in Medina, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. APRN.CNP.024656 (OH). The NPI Number for KEITH KOPISCH (APRN) is 1124684220

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
KEITH KOPISCH (APRN)
NPI
1124684220
Phone
Not provided
Address
1000 E WASHINGTON ST
Enumeration Date
14 May 2019
Last Update Date
12 February 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3307251000
Graduation Year
2019 (7 years ago)
PAC ID
5092141762
Group Practice PAC ID
3072410125
Professional Enrollment ID
I20200227000959
Address ID
OH442562170ME1000XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:7State licenses:1Digital endpointsOther names

14,984 NURSE PRACTITIONER in OH

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Provider Addresses for KEITH KOPISCH (APRN)

  • Cleveland Clinic Medina Hospital, 1000, East Washington Street, Medina, Medina County, Ohio, 44212, United States

    MEDINA, OH 442562170

    Phone:

    Mailing address matches the actual address.

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: 2020-02-27

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
I20200227000959INurse PractitionerOHTBD

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
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes7467$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes3836$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes2020$0
View full utilization report →

Insurance plans in this area (ZIP 44256)

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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: 3072410125View full group profile
NameSpecialtyState
Physician AssistantOH
Physician AssistantOH
Physician AssistantOH
Nurse PractitionerOH
Nurse PractitionerOH
Nurse PractitionerOH
Nurse PractitionerOH
Physician AssistantOH
-OH
Nurse PractitionerOH

Reviews

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Frequently asked questions

What is the 10-digit NPI for KEITH KOPISCH (APRN)?
KEITH KOPISCH (APRN) — NPI 1124684220 — is the standard way to identify this listing.
Does CMS list KEITH KOPISCH (APRN) as active?
Yes — KEITH KOPISCH (APRN) is active in the NPI listing used on this page.
What healthcare role does KEITH KOPISCH (APRN) hold?
Scheduling teams often label KEITH KOPISCH (APRN) under Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What address line appears for KEITH KOPISCH (APRN)?
KEITH KOPISCH (APRN)'s geographic hint is Medina, Ohio in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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