Hariton Kousourou, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

156800 Issued in NY

Practice address

45 Route 25a
Suite C
Shoreham, NY 11786-1389

Phone

(631) 821-2626

Fax

(631) 744-1627

NPI assigned

Oct 3, 2006

Last updated

Nov 27, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Internal Medicine

Education

State University of New York at Buffalo School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bronson Lakeview HospitalGroup PAC ID 9032008495, 72 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bronson at Home Healthcare Services Home health agency, Battle Creek, MI, CCN 237028
• Mary Free Bed at Home, LLC Home health agency, Grand Rapids, MI, CCN 237203
• Bronson Lakeview Hospital Hospital, Paw Paw, MI, CCN 231332
• Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
• Bronson South Haven Hospital Hospital, South Haven, MI, CCN 230085
• Bassett Healthcare Hospital, Cooperstown, NY, CCN 330136

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: direct@direct.bronsonhg.org
• Direct secure messaging: hkousourou95286@direct.bronsonhg.org
• FHIR API: https://api.platform.athenahealth.com/24863/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bronson Lakeview Hospital

  dba Bronson Medical Group

  • Internal Medicine Physician
  • Paw Paw, MI
  • NPI 1235131137
  Medicare reassignment Care Compare group NPD
• Primary Partnercare Physicians PLLC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1891318168
  NPD
• Bronson Lakeview Hospital

  dba Bronson LakeView Family Care-Blue Star

  • Rural Health Clinic/Center
  • South Haven, MI
  • NPI 1801538871
  NPD
• Shoreham Medical Services P.C.

  • Internal Medicine Physician
  • Shoreham, NY
  • NPI 1164691879
  NPD (past)

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

• Mary Imogene Bassett Hospital

  dba Bassett Healthcare

  • Rural Acute Care Hospital
  • Cooperstown, NY
  • NPI 1780600577
  Care Compare affiliation
• Bronson at Home

  • Home Health Agency
  • Battle Creek, MI
  • NPI 1376524090
  Care Compare affiliation
• Bronson Lakeview Hospital

  • Critical Access Hospital
  • Paw Paw, MI
  • NPI 1962508259
  Care Compare affiliation
• Bronson Methodist Hospital

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1831116441
  Care Compare affiliation
• Bronson South Haven Hospital

  • General Acute Care Hospital
  • South Haven, MI
  • NPI 1346275856
  Care Compare affiliation
• Mary Free Bed at Home, LLC

  • Home Health Agency
  • Grand Rapids, MI
  • NPI 1023477478
  Care Compare affiliation

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1326133646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 HEALTH PARKWAY",
            "address_2": "SUITE F",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "49079",
            "telephone_number": "269-655-3080",
            "fax_number": "269-655-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 ROUTE 25A",
            "address_2": "SUITE C",
            "city": "SHOREHAM",
            "state": "NY",
            "postal_code": "117861389",
            "telephone_number": "631-821-2626",
            "fax_number": "631-744-1627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUSOUROU",
        "first_name": "HARITON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "156800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01026700",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joann Johannessen
• Nimisha P Joshi, R.PH
• Annmarie Kane, CCC-SLP
• Peter Andrew Kaufmann, DC
• Caitlin Margaret Kelly
• Jeffrey Kraushaar, O.D.
• Justin Daniel Kraushaar, O.D.
• Karen Krol-Reilly, PTA
• Richard Kubiak, MD
• Christine Lange, SLP

• Internal Medicine Physician in Shoreham, NY
• Providers in Shoreham, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.