GLENN ALAN KOESTER MD NPI 1790892461

NPI Information

  • NPI: 1790892461
  • Provider Name: GLENN ALAN KOESTER, MD
  • Classification: Dermatology - 207NS0135X
  • Specialization: Procedural Dermatology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3863 S. BOULEVARD
    EDMOND, OK
    ZIP 73034
  • Phone: (405) 216-5444

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NPI Details

Glenn Alan Koester, MD is a procedural dermatology dermatology in Edmond, OK. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). Glenn Alan Koester, MD NPI is 1790892461. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3863 S. BOULEVARD
EDMOND, OK
ZIP 73034
Phone: (405) 216-5444
Fax: (405) 216-5445

The NPI 1790892461 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Destruction of precancer skin growth, 2-14 growths (HCPCS:17003)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Destruction of precancer skin growth, 1 growth (HCPCS:17000)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
  • Biopsy of related skin growth, first growth (HCPCS:11102)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Destruction of skin growth, 1-14 growths (HCPCS:17110)
  • Biopsy of related skin growth, each additional growth (HCPCS:11103)
  • Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm (HCPCS:17262)
  • Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm (HCPCS:12052)
  • Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm (HCPCS:11642)
  • Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm (HCPCS:12032)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Destruction of precancer skin growth, 15 or more growths (HCPCS:17004)
  • Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm (HCPCS:11602)
  • Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm (HCPCS:11301)
  • Punch biopsy, first skin growth (HCPCS:11104)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm (HCPCS:17272)
  • Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm (HCPCS:17282)
  • New patient office or other outpatient visit, 15-29 minutes (HCPCS:99202)

The enumeration date for this NPI number is 8/25/2006 and was last updated on 7/19/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207NS0135XDermatologyProcedural Dermatology18783OKLAHOMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1F75603MEDICARE UPINOKLAHOMA
2241413204MEDICARE ID-TYPE UNSPECIFIEDOKLAHOMAINDIVIDUAL
3100152170BMEDICAIDOKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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