Raghad Koutouby, M.D

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

ME0055947 Issued in FL

Practice address

8525 SW 92ND St Ste C11A
Miami, FL 33156-7386

Phone

(305) 512-3345

Fax

(844) 323-3689

NPI assigned

Jun 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Pediatric Medicine

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Miami Pediatric Gastroenterology LLCGroup PAC ID 2365705217, 2 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Miami Pediatric Gastroenterology LLC

  • Specialist
  • Miami, FL
  • NPI 1679937742
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1043259468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8525 SW 92ND ST STE C11A",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331567386",
            "telephone_number": "305-512-3345",
            "fax_number": "844-323-3689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8525 SW 92ND ST STE C11A",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331567386",
            "telephone_number": "305-512-3345",
            "fax_number": "844-323-3689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUTOUBY",
        "first_name": "RAGHAD",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "FL",
            "license": "ME0055947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373857400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kellye Marie Koubek, APRN
• Beatrice Koubi, OT
• Tamara Koubi
• Chrissy Nikki Koulouris, M.S.
• Jerry Kourkoumelis, MD
• Irena Kovac
• Jaclyn Kovach, MD
• Christina Michelle Kovacs, M.D.
• Margaret Kovacs, ARNP
• Andrea Z Koven, O.D.

• Pediatric Gastroenterology Physician in Miami, FL
• Providers in Miami, FL by specialty
• Pediatric Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.