Heather Kopecky

Public-record details

Address

317 N Washington Ave, Clearwater, FL 33755

Phone

(503) 459-6902

Listed under

Individual clinicians

NPI

1922566249

NPI status

Active in the NPPES registry

Provider type

Individual provider

Registered specialty (self-reported taxonomy)

Dermatology (207N00000X)

License number on NPI record

103231 (GA)

NPI first issued

Mar 5, 2019

Years since NPI first issued

7 years (since 2019)

License state on NPI record

GA

NPI record last updated

Mar 27, 2025

Medicare enrollment (CMS)

Enrolled: listed in CMS Doctors & Clinicians

Medicare assignment (CMS)

Accepts the Medicare-approved amount as payment in full

Professional school graduation (CMS)

2021 (5 years ago)

Professional school (CMS)

Col of Osteo Med of the Pacific at Lebanon

Medicare group practice (CMS)

Aqua Dermatology of Georgia PC (58 clinicians)

Practice locations on file with Medicare (CMS)

1

NPI 1922566249 is active in the federal NPPES registry (CMS) with Dermatology as its self-reported primary taxonomy; license 103231 (GA) is listed on the record. CMS Doctors & Clinicians lists this clinician as enrolled in Medicare. Source: NPPES NPI Registry (CMS) (record). Data as of 2026-10-16.

Public record, not an endorsement. This listing was compiled from public records as of 2026-10-16 and may be incomplete or out of date. Dermatologist Index does not vet, employ, recommend or guarantee dermatology practices; a badge reflects only what the public record showed on that date. Confirm current details with the official record before you decide. The information on Dermatologist Index is not medical advice and does not replace a doctor, nurse, discharge planner or other qualified professional. Do not use it to make decisions about diagnosis or treatment. If you have a medical emergency, call 911. Full disclaimer · Report an error

What these registry facts mean

The NPI (National Provider Identifier) is the federal ID every HIPAA-covered provider uses to bill insurance. This NPI belongs to an individual clinician. The specialty is the taxonomy the provider chose when registering; NPPES does not check it. A license number here is what the provider entered — confirm it with the state board before you rely on it. A registered specialty is not board certification. To check board certification, use the American Board of Dermatology's verification tool (or the American Osteopathic Board of Dermatology for DOs), and confirm the medical license with the state board.

View NPI 1922566249 in the official registry ↗