Individual provider Active NPI

Soultana Kourtidou, MD, MSC

  • Pediatric Cardiology Physician
  • Brooklyn, NY
National Provider Identifier
1225314495
Registry record updated Nov 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
296478 Issued in NY
Practice address
263 7TH Ave
Brooklyn, NY 11215-7247
Phone
(718) 780-5260
NPI assigned
Nov 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 296478 NY Primary

Addresses

Primary practice location

263 7TH Ave
Brooklyn, NY 11215-7247

Mailing address

237 11TH St Apt 10B
Brooklyn, NY 11215-4537
Phone (516) 503-1010

Other practice location 1

525 E 68th St # F677
New York, NY 10065-4870
Phone (718) 960-3730

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190205002672 NY Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 1557678513 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Pediatric Group CurrentSince Apr 8, 2020 Accepting new patients
Weill Medical College of Cornell Pediatric Cardiology CurrentSince Dec 16, 2018 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
Kings Physician Services, PC CurrentSince Jan 5, 2019 Accepting new patients
Weill Medical College of Cornell CurrentSince Dec 16, 2018 Accepting new patients
Kings Physician Services, PC CurrentSince Jan 5, 2019 Accepting new patients

Locations

263 7th Ave
Brooklyn, NY 11215
Phone (718) 246-8510

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

525 E 68th St
#F677
New York, NY 10065
Phone (212) 746-0205

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

525 E 68th St
#M6
New York, NY 10065
Phone (212) 746-3558

1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415

Interoperability endpoints

  • Direct secure messaging: sok9030@direct.weillcornell.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1225314495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 11TH ST APT 10B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112154537",
            "telephone_number": "516-503-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 7TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112157247",
            "telephone_number": "718-780-5260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 E 68th St # F677",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100654870",
            "country_code": "US",
            "telephone_number": "718-960-3730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOURTIDOU",
        "first_name": "SOULTANA",
        "credential": "MD, MSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-01",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "296478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.