Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jesse R Kooistra, FNP

Individual provider Basic Emergency Medical Technician · NPI 1467251496

Jesse R Kooistra, FNP is a Nurse Practitioner in Warsaw, Indiana. Qualified in 2025, 1 year ago. Practices with Medstat LLC, an 8-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
1
Licensed in
IN
In the registry since
2025
Specialties on file
4
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

See every abbreviation used in this directory →

Practice location Address checks out

1500 Provident Dr Ste A
Warsaw, IN 46580-3297
Phone: (574) 372-7637
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 600 East Blvd, Elkhart, IN 46514-2483 — (406) 468-5767

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 71016732A (IN)
Basic Emergency Medical Technician Taxonomy 146N00000X
Emergency Registered Nurse Taxonomy 163WE0003X · Licence E3105472 (IN)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence E3105472 (IN)

Record details

NPI number1467251496
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP
Sole proprietorNo
NPI enumeratedMarch 11, 2025
Last updated in NPPESJuly 18, 2025
Certification dateJuly 18, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Medstat Llc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount