Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Krista Marie Koppenberger, PA-C

Individual provider Physician Assistant · NPI 1598339517

Krista Marie Koppenberger, PA-C is a Physician Assistant in Ormond Beach, Florida. Qualified in 2020, 6 years ago. Practices with Lisa D Zack MD PA, a 6-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
6
Licensed in
FL
In the registry since
2021
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

802 Sterthaus Dr
Ormond Beach, FL 32174-5116
Phone: (407) 299-7333
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7652 Ashley Park Ct Ste 305, Orlando, FL 32835-6199 — (407) 299-7333

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9114379 (FL)

Record details

NPI number1598339517
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 14, 2021
Last updated in NPPESOctober 18, 2021
Certification dateOctober 18, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Lisa D Zack Md Pa — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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