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

Lisa Koop

Individual provider Certified Registered Nurse Anesthetist · NPI 1265160881

Lisa Koop is a Certified Registered Nurse Anesthetist (CRNA) in Fort Wayne, Indiana. Qualified in 2022, 4 years ago. Practices with Anesthesia Dynamics LLC, a 880-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
4
Licensed in
IN
In the registry since
2022
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Practice location Address checks out

5050 N Clinton St
Fort Wayne, IN 46825-5886
Phone: (260) 484-8551
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 28193681A (IN)

Record details

NPI number1265160881
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 11, 2022
Last updated in NPPESAugust 11, 2022
Certification dateAugust 11, 2022

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Anesthesia Dynamics Llc — 880 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Fort Wayne