Dimitri J Koumanis, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

256948 Issued in NY

Practice address

13 Chester Street
Glens Falls, NY 12801-4432

Phone

(518) 203-2593

Fax

(518) 314-0701

NPI assigned

Oct 31, 2006

Last updated

Feb 25, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physical Medicine and Rehabilitation

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Capital Area Plastic Surgery, PLLC

  • Specialist
  • Saratoga Springs, NY
  • NPI 1124327341
  Medicare reassignment NPD
• Champlain Valley Physicians Hospital Medical Center

  • Internal Medicine Physician
  • Plattsburgh, NY
  • NPI 1124189782
  Medicare reassignment NPD
• Koumanis Medical, PLLC

  • Plastic Surgery Physician
  • Queensbury, NY
  • NPI 1558192211
  Medicare reassignment NPD
• Koumanis Diet Health Clinic of Michigan, PLLC

  • Plastic Surgery Physician
  • Warren, MI
  • NPI 1811892185
  Authorized official Same address or phone

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1003992926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 CHESTER STREET",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014432",
            "telephone_number": "518-203-2593",
            "fax_number": "518-314-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 CHESTER STREET",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014432",
            "telephone_number": "518-203-2593",
            "fax_number": "518-314-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUMANIS",
        "first_name": "DIMITRI",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "256948",
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NY",
            "license": "002733",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Teakle Klippel, PHARMACIST
• Kelly A Knill, RPA-C
• Carly Michelle Koelsch, CNM
• Morris Kopels, M.D.
• Kasuni Kotelawala, MD
• Molly Beth Kovalesky, DDS
• Leah Nicole Kowalski, CPT
• Carwyn M Kruler, CNM
• Leslee S Kunst, RN
• Todd Kuntz, PSY. D.

• Plastic Surgery Physician in Glens Falls, NY
• Providers in Glens Falls, NY by specialty
• Plastic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.