Deactivated NPI 1851388391 Deactivated / Inactive NPI Male Practitioner

Dr. Keith Robert Koepke , MD

Internal Medicine • Brooklyn, OH

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Keith Koepke has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 30, 2005

NPI Deactivation Date October 25, 2023

Total Practice Duration ~18 Years of Practice (2005 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Keith Koepke, MD was a registered Internal Medicine practicing in Brooklyn, OH. Throughout an active medical career spanning 18 years, Dr. Koepke provided care at the practice location at 7575 NORTHCLIFF AVE until profile deactivation on 2023-10-25.

Historical Medicare Part B clinical services included established patient outpatient office visit, chronic care management services, first, routine ekg using at least 12 leads including interpretation and report. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

7575 Northcliff Ave
#400

Brooklyn, OH 441443267

Telephone 2167498276

Fax 2167498240

Associated Practice Facility / Clinic

🏢 Regional Diagnostics Llc Facility NPI 1578551941

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Brooklyn, OH

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 26.9 Yrs

Regional Practice Density

8 Specialists

Practicing in Brooklyn, OH (5516 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

35.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2023)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	113	86	$178.00	$121.36
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	34	13	$100.00	$59.74
93000 Routine ekg using at least 12 leads including interpretation and report	27	26	$58.00	$13.76
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	25	25	$154.00	$122.52

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	236	110	$178.00	$123.39
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	174	30	$100.00	$61.36
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	89	89	$154.00	$125.92
93000 Routine ekg using at least 12 leads including interpretation and report	84	83	$58.00	$13.78
99213 Established patient office or other outpatient visit, typically 15 minutes	45	38	$120.00	$87.92
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	32	13	$37.00	$13.71
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	28	27	$100.00	$70.11
G0008 Administration of influenza virus vaccine	26	26	$37.00	$27.95
83036 Hemoglobin A1C level	17	13	$30.00	$9.59
69210 Removal of impacted ear wax	12	11	$126.00	$46.14

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	257	120	$178.00	$125.33
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	188	24	$100.00	$39.28
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	94	94	$154.00	$128.66
93000 Routine ekg using at least 12 leads including interpretation and report	92	89	$58.00	$14.34
99213 Established patient office or other outpatient visit, typically 15 minutes	66	47	$120.00	$88.33
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	55	12	$32.00	$21.64
G0008 Administration of influenza virus vaccine	25	25	$37.00	$16.19
90653 Vaccine for influenza for injection into muscle	25	25	$75.00	$59.53
83036 Hemoglobin A1C level	20	15	$30.00	$9.71
77080 Dxa bone density measurement of hip, pelvis, spine	12	12	$168.00	$36.10

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	278	118	$178.00	$105.05
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	147	19	$100.00	$40.59
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	93	93	$154.00	$111.90
93000 Routine ekg using at least 12 leads including interpretation and report	90	88	$58.00	$16.45
99213 Established patient office or other outpatient visit, typically 15 minutes	64	44	$120.00	$72.25
G0008 Administration of influenza virus vaccine	34	33	$37.00	$16.05
90653 Vaccine for influenza for injection into muscle	31	31	$75.00	$59.49
83036 Hemoglobin A1C level	26	18	$30.00	$9.68
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	16	14	$25.00	$1.44
69210 Removal of impacted ear wax	14	13	$126.00	$45.41

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	314	137	$178.00	$103.78
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	187	36	$100.00	$40.08
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	106	106	$154.00	$110.74
93000 Routine ekg using at least 12 leads including interpretation and report	105	101	$58.00	$16.23
99213 Established patient office or other outpatient visit, typically 15 minutes	92	66	$120.00	$70.37
83036 Hemoglobin A1C level	41	29	$30.00	$10.57
G0008 Administration of influenza virus vaccine	35	35	$37.00	$15.30
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	22	12	$37.00	$15.82
90653 Vaccine for influenza for injection into muscle	20	20	$75.00	$55.42
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	19	13	$25.00	$1.58
90756 Vaccine for influenza for injection into muscle	17	17	$40.00	$25.91
69210 Removal of impacted ear wax	16	15	$126.00	$44.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	390	147	$179.39	$103.48
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	117	117	$156.22	$111.79
93000 Routine ekg using at least 12 leads including interpretation and report	117	111	$31.85	$16.18
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	116	29	$100.00	$40.58
85610 Blood test, clotting time	106	11	$9.87	$4.75
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	57	11	$5.00	$1.66
99213 Established patient office or other outpatient visit, typically 15 minutes	36	32	$120.00	$68.04
G0008 Administration of influenza virus vaccine	35	35	$37.23	$19.30
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	30	29	$244.00	$140.31
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	27	13	$39.07	$19.40
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	21	21	$143.81	$105.59
G0009 Administration of pneumococcal vaccine	21	21	$37.38	$19.30
90756 Vaccine for influenza for injection into muscle	20	20	$39.80	$22.33
90653 Vaccine for influenza for injection into muscle	15	15	$85.00	$53.58
69210 Removal of impacted ear wax	14	14	$126.00	$46.84
77080 Dxa bone density measurement of hip, pelvis, spine	11	11	$78.09	$39.14

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	392	164	$219.87	$102.85
36415 Insertion of needle into vein for collection of blood sample	190	123	$9.00	$2.93
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	134	134	$216.12	$110.51
93000 Routine ekg using at least 12 leads including interpretation and report	128	127	$85.00	$16.13
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	91	62	$273.02	$139.02
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	38	14	$42.89	$23.93
G0008 Administration of influenza virus vaccine	25	25	$36.00	$23.76
99213 Established patient office or other outpatient visit, typically 15 minutes	22	22	$115.00	$65.90
69210 Removal of impacted ear wax	21	20	$128.10	$47.03
G0009 Administration of pneumococcal vaccine	19	19	$41.05	$23.76
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	18	18	$149.33	$95.90
77080 Dxa bone density measurement of hip, pelvis, spine	14	14	$274.29	$38.08
Q2037 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)	13	13	$25.00	$17.34

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License OH 05-031822

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners

Bonnie Behm , CNP

Nurse Practitioner - Family

NPI 1417194903

Certified Nurse Practitioner

Dr. Charles Koepke , MD

Internal Medicine

NPI 1518951193

Doctor of Medicine (M.D.)

Dr. Michael Silverman , MD

Internal Medicine

NPI 1770575458

Doctor of Medicine (M.D.)

Joan Nunnery , APN-C

Nurse Practitioner - Gerontology

NPI 1952397150

APNC

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

18 Historical Events

⚠️

NPI Profile Deactivated October 25, 2023

Record deactivated on October 25, 2023

📍

Updated Practice Location May 31, 2018

Registered at 1440 ROCKSIDE RD STE 202, PARMA, OH 44134 (Tel: 2167498276)

✅

NPI Profile Active February 23, 2018

NPI status registered as active in NPPES database

📍

Updated Business Mailing Address February 23, 2018

Registered at 1440 ROCKSIDE RD STE 202, PARMA, OH 441342749 (Tel: 2167498256)

📍

Updated Practice Location February 23, 2018

Registered at 1440 ROCKSIDE RD STE 202, PARMA, OH 441342749 (Tel: 2167498256)

👤

Provider Name / Credentials Updated February 23, 2018

Recorded as KEITH KOEPKE, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 23, 2018

Internal Medicine (License #05-031822 in OH)

✅

NPI Profile Active October 26, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location October 26, 2017

Registered at 1440 ROCKSIDE RD STE 202, PARMA, OH 441342749 (Tel: 2167498256)

📍

Updated Business Mailing Address October 26, 2017

Registered at PO BOX 378, SANDUSKY, OH 448710378

👤

Provider Name / Credentials Updated October 26, 2017

Recorded as KEITH KOEPKE, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 26, 2017

Internal Medicine (License #05-031822 in OH)

✅

NPI Profile Active May 30, 2008

NPI status registered as active in NPPES database

📍

Updated Practice Location May 30, 2008

Registered at 7575 NORTHCLIFF AVE, #400, BROOKLYN, OH 441443267 (Tel: 2167498276)

📍

Updated Business Mailing Address May 30, 2008

Registered at 7575 NORTHCLIFF AVE, #400, BROOKLYN, OH 441443267 (Tel: 2167498276)

👤

Provider Name / Credentials Updated May 30, 2008

Recorded as KEITH KOEPKE, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 30, 2008

Internal Medicine (License #05-031822 in OH)

🟢

Initial NPI Registration & Enumeration September 30, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1851388391

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: September 30, 2005

Last Update: May 30, 2008

Deactivation Date: October 25, 2023

Update or Correct Profile

Mailing Address

7575 Northcliff Ave, #400

Brooklyn, OH 441443267

Phone: 2167498276

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.