Individual provider Active NPI

Sotirios Koros, D.O.

  • Family Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1013270768
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34011943 Issued in OH
Practice address
4421 Eastgate Blvd
Suite 300
Cincinnati, OH 45245-4501
Phone
(513) 752-8000
Fax
(513) 752-1078
NPI assigned
Jun 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 34011943 OH Primary

Addresses

Primary practice location

4421 Eastgate Blvd
Suite 300
Cincinnati, OH 45245-4501

Mailing address

4421 Eastgate Blvd
Suite 300
Cincinnati, OH 45245-4501
Phone (513) 752-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20151023000245 OH Practitioner - Family Practice 0840443412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians Cincinnati LLCGroup PAC ID 6709790892, 191 clinicians

Practice addresses (Care Compare)

4421 Eastgate Blvd
Suite 300
Cincinnati, OH 45245-4501
Phone (513) 752-8000

Hospital & facility affiliations

  • Mercy Health - West Hospital Hospital, Cincinnati, OH, CCN 360234
  • Mercy Health - Clermont Hospital Hospital, Batavia, OH, CCN 360236
  • Mercy Health-Anderson Hospital Hospital, Cincinnati, OH, CCN 360001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34011943OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Cincinnati, LLC Family Medicine CurrentSince Dec 1, 2015 Accepting new patients
Mercy Health Physicians Cincinnati LLC CurrentSince Dec 1, 2015 Accepting new patients

Locations

4421 Eastgate Blvd
Ste 300
Cincinnati, OH 45245
Phone (513) 752-8000

2446 Kipling Ave
Cincinnati, OH 45239
Phone (513) 583-8500

601 Ivy Gtwy
Ste 2100
Cincinnati, OH 45245
Phone (513) 216-1263

Networks

  • devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
  • KY PPO C-SNP
  • devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8
  • KY PPO
  • OH PPO
  • devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9

Interoperability endpoints

  • Direct secure messaging: skoros195501@direct.bsmhealth.org

Organizations & group practices 2

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1013270768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 EASTGATE BLVD",
            "address_2": "SUITE 300",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452454501",
            "telephone_number": "513-752-8000",
            "fax_number": "513-752-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 EASTGATE BLVD",
            "address_2": "SUITE 300",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452454501",
            "telephone_number": "513-752-8000",
            "fax_number": "513-752-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROS",
        "first_name": "SOTIRIOS",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-18",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34011943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.