Kim Krystal Koike, OTR is a medicare enrolled "Occupational Therapist" physician in Waukesha, Wisconsin. Her current practice location is
3712 Fiddlers Creek Dr., Waukesha, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(314) 640-4724.
Kim Krystal Koike is licensed to practice in Wisconsin (license number 6645-26) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1699279604.
Physician's Profile
| Full Name | Kim Krystal Koike |
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| Gender | Female |
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| Speciality | Occupational Therapist |
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| Location | 3712 Fiddlers Creek Dr., Waukesha, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1699279604
- Provider Enumeration Date: 03/23/2018
- Last Update Date: 06/07/2023
Medicare PECOS Information:
- PECOS PAC ID: 7719345875
- Enrollment ID: I20230621002823
Medical Identifiers
Medical identifiers for Kim Krystal Koike such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1699279604 | NPI | - | NPPES |
| 001148 | Other | MO | ERGONOMICS/INJURY PREVENTION & OCCUPATIONAL THERAPY |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2083P0500X | Preventive Medicine - Preventive Medicine/occupational Environmental Medicine | 001148 (Missouri) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | 001148 (Missouri) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 001148 (Missouri) | Secondary |
| 225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
| 225X00000X | Occupational Therapist | 6645-26 (Wisconsin) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kim Krystal Koike allows following entities to bill medicare on her behalf.
| Entity Name | Oasis Therapy Services Llc |
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| Entity Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Entity Identifiers | NPI Number: 1386381598
PECOS PAC ID: 8325427974
Enrollment ID: O20220706002370 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kim Krystal Koike is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Kim Krystal Koike, OTR
2014 S 102nd St Apt 309,
West Allis, WI 53227-1350
Ph: (314) 640-4724 | Kim Krystal Koike, OTR
3712 Fiddlers Creek Dr.,
Waukesha, WI 53188
Ph: (314) 640-4724 |
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