Jaret Koudelka, PHARM. D.
NPI 1487331625ActiveIndividual· Pharmacist· Caldwell, ID
Pharmacist (PHARM. D.) in Caldwell, Idaho, licensed in ID and OR, with an NPI issued in June 2023. Part D covered 15 prescriptions written in 2024, 93% of them generic.
Overview
| NPI | 1487331625 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHARM. D. |
| Sole proprietor | No |
| NPI issued | Jun 29, 2023 |
| Last updated in NPPES | Aug 31, 2026 |
| Certified by provider | Aug 31, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacist Primary | 183500000X | P10716 | ID |
| Pharmacist | 183500000X | RPH-0021039 | OR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 15 · 37 30-day fills |
|---|---|
| Total drug cost | $157.94 |
| Generic share | 93% of claims |
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