Organization Active NPI

Konstantinos Koutros

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1306195524
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
KONSTANTINOS KOUTROS
Practice address
9101 4TH Ave
Brooklyn, NY 11209-6368
Phone
(718) 283-8773
NPI assigned
Sep 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Authorized official

Name
Konstantinos Koutros
Title
Owner
Phone
(718) 283-8773

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X NY Primary

Addresses

Primary practice location

9101 4TH Ave
Brooklyn, NY 11209-6368

Mailing address

9101 4TH Ave
Brooklyn, NY 11209-6368

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0888308Konstantinos Koutros MD9101 4TH Avenue, Brooklyn, NY 11209ComplianceMar 26, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1346716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346716800000",
    "number": "1306195524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112096368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112096368",
            "telephone_number": "718-283-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KONSTANTINOS KOUTROS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-04",
        "last_updated": "2012-09-04",
        "status": "A",
        "authorized_official_last_name": "KOUTROS",
        "authorized_official_first_name": "KONSTANTINOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-283-8773"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.