Active NPI
Peter Constantine Koumas, DO
- Ophthalmology Physician
- Dayton, OH
National Provider Identifier
1073611877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 34003248K
- Practice address
- 105 Sugar Camp Cir
Ste 200
Dayton, OH 45409-1962 - Phone
- (937) 222-3937
- Fax
- (937) 223-5416
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 34003248K | OH | Primary |
Addresses
Primary practice location
105 Sugar Camp Cir
Ste 200
Dayton, OH 45409-1962
Mailing address
105 Sugar Camp Cir
Ste 200
Dayton, OH 45409-1962
Phone (937) 222-3937
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0552469 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34003248K | OH | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384387200000",
"number": "1073611877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 SUGAR CAMP CIR",
"address_2": "STE 200",
"city": "DAYTON",
"state": "OH",
"postal_code": "454091962",
"telephone_number": "937-222-3937",
"fax_number": "937-223-5416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 SUGAR CAMP CIR",
"address_2": "STE 200",
"city": "DAYTON",
"state": "OH",
"postal_code": "454091962",
"telephone_number": "937-222-3937",
"fax_number": "937-223-5416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOUMAS",
"first_name": "PETER",
"middle_name": "CONSTANTINE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2013-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "OH",
"license": "34003248K",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0552469",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.