Mary M Koumas, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A4402 Issued in CA

Practice address

24401 Muirlands Blvd
Suite #a
Lake Forest, CA 92630-3948

Phone

(949) 770-1950

Fax

(949) 770-8599

NPI assigned

Aug 19, 2005

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Family PracticeAlso: Osteopathic Manipulative Medicine

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lake Forest Medical Group, Inc.Group PAC ID 3274594650, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: mary.koumas.p37@direct.monarchhealthcare.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Lake Forest Medical Group, Inc.

  • Family Medicine Physician
  • Lake Forest, CA
  • NPI 1558429092
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saddleback Memorial Medical Center

  • General Acute Care Hospital
  • Laguna Hills, CA
  • NPI 1275576381
  Care Compare affiliation

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228780800000",
    "number": "1306838909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24401 MUIRLANDS BLVD",
            "address_2": "SUITE #A",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926303948",
            "telephone_number": "949-770-1950",
            "fax_number": "949-770-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24401 MUIRLANDS BLVD",
            "address_2": "SUITE #A",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926303948",
            "telephone_number": "949-770-1950",
            "fax_number": "949-770-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUMAS",
        "first_name": "MARY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2008-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A4402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cherie Knopf, ADMINISTRATOR
• Tanja Kolthof
• Ashley Vanessa Kooh
• Carolyn Kopper, P.T.
• Carolyn Korbel, PH.D.
• Kourosh Rahimpour DDS, PC (OC Family Dentistry)
• Kowalik Chiropractic Inc (Kowalik Family Chiropractic)
• Daryl G Kowalik, D.C.
• Kerri Kratzer
• James Kuechler, M.D.

• Family Medicine Physician in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; 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.