NPIMap

Organization Active NPI

Konstantinos Koutelos, M.D. & Irina Krym Physician, P.C.

  • Cardiovascular Disease Physician
  • Brooklyn, NY
National Provider Identifier
1003909839
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
KONSTANTINOS KOUTELOS, M.D. & IRINA KRYM PHYSICIAN, P.C.
Practice address
8401 Fort Hamilton Pkwy
Brooklyn, NY 11209-4805
Phone
(718) 759-0105
Fax
(718) 759-0800
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Konstantinos Koutelos, M.D.NPI 1467545269
Title
Partner
Phone
(718) 759-0105

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

8401 Fort Hamilton Pkwy
Brooklyn, NY 11209-4805

Mailing address

8401 Fort Hamilton Pkwy
Brooklyn, NY 11209-4805
Phone (718) 759-0105

Other identifiers 3

IdentifierTypeStateIssuer
01849825MedicaidNY
01428293MedicaidNY
01793324MedicaidNY

National Provider Directory

National Provider Directory

Locations

8401 Fort Hamilton Pkwy
Brooklyn, NY 11209
Phone (718) 759-0105

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346803200000",
    "number": "1003909839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 FORT HAMILTON PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112094805",
            "telephone_number": "718-759-0105",
            "fax_number": "718-759-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 FORT HAMILTON PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112094805",
            "telephone_number": "718-759-0105",
            "fax_number": "718-759-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KONSTANTINOS KOUTELOS, M.D. & IRINA KRYM PHYSICIAN, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2012-09-05",
        "status": "A",
        "authorized_official_last_name": "KOUTELOS",
        "authorized_official_first_name": "KONSTANTINOS",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "718-759-0105",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01849825",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01428293",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01793324",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.