Individual provider Active NPI

Nicholas G Kambouris, MD

  • Anesthesiology Physician
  • Washington, DC
National Provider Identifier
1144254467
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD31519 Issued in DC
Practice address
110 Irving St NW
Washington, DC 20010-2976
Phone
(301) 946-5100
Fax
(301) 929-0348
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD31519 DC Primary

Addresses

Primary practice location

110 Irving St NW
Washington, DC 20010-2976

Mailing address

11510 Georgia Ave
Suite 206
Wheaton, MD 20902-1925
Phone (301) 946-5100

Other identifiers 8

IdentifierTypeStateIssuer
501329OtherDCNCPPO
9431215002OtherDCCIGNA HMO
209468OtherDCKAISER
0108OtherDCCAREFIRST BCBS
5366647OtherDCAETNA NON HMO
441040OtherVAANTHEM BCBS
2495273OtherDCAETNA HMO
5704634MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101207001012 DC Practitioner - Anesthesiology 1850588559 Reassigns benefits to 2 organizations
I20220426000026 MD Practitioner - Anesthesiology 1850588559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Virginia School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

Hospital & facility affiliations

  • Medstar Washington Hospital Center Hospital, Washington, DC, CCN 090011

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients
Medstar Medical Group Anesthesiology LLC Anesthesiology CurrentSince Jun 1, 2018 Accepting new patients
Medstar Medical Group Anesthesiology LLC Anesthesiology CurrentSince Jun 1, 2018 Accepting new patients
Washington Hospital Center Corp Anesthesiology Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

2000 15th St N
Ste 600
Arlington, VA 22201
Phone (202) 425-0000

Organizations & group practices 5

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 1

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1144254467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11510 GEORGIA AVE",
            "address_2": "SUITE 206",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209021925",
            "telephone_number": "301-946-5100",
            "fax_number": "301-929-0348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102976",
            "telephone_number": "301-946-5100",
            "fax_number": "301-929-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMBOURIS",
        "first_name": "NICHOLAS",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "DC",
            "license": "MD31519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "501329",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HMO",
            "identifier": "9431215002",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "209468",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "0108",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON HMO",
            "identifier": "5366647",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "441040",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2495273",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5704634",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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Sources for this page

Verify at the official NPI Registry.