Georgia Maria Kousoulis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0006463 Issued in MD

Practice address

100 E Carroll St
Salisbury, MD 21801-5422

Phone

(410) 543-7536

NPI assigned

Mar 11, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019

Merit-based Incentive Payment System (MIPS)

Final score

82.92 of 100Reported as group

Quality

74.47

Promoting interoperability

92

Improvement activities

40

Cost

75.27

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Tidalhealth Specialty Care, LLC

  • Medical Specialty Clinic/Center
  • Salisbury, MD
  • NPI 1619504735
  Medicare reassignment Care Compare group
• Tidalhealth Peninsula Regional, Inc.

  • Family Medicine Physician
  • Salisbury, MD
  • NPI 1184832040

  Physician Assistant

  Medicare reassignment NPD
• Tidalhealth Peninsula Regional, Inc.

  • Community/Retail Pharmacy
  • Salisbury, MD
  • NPI 1871031559
  NPD

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

• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  Care Compare affiliation

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

{
    "created_epoch": "1236729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1376784918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "410-546-6400",
            "fax_number": "410-630-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "410-543-7536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34434 King Street Row Ste 2",
            "address_purpose": "LOCATION",
            "city": "Lewes",
            "state": "DE",
            "postal_code": "199584787",
            "country_code": "US",
            "telephone_number": "302-644-8880",
            "fax_number": "302-644-8882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOUSOULIS",
        "first_name": "GEORGIA",
        "middle_name": "MARIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-11",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "DE",
            "license": "C5-0000659",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0006463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Konlian,O'Neill & Associates, P.a.
• Angela G Korb, MS, PA-C
• Matthew A Kosloski
• Sydney Paige Koteff, LMSW
• Deanna Kotzur, PA
• Andras Kovacs, M.D.
• Elizabeth K Koval, MD
• Gopal Chandru Kowdley, M.D., PHD, FACS
• Karla Michele Kramer, COTAL
• Larry Kramer, CRNP

• Physician Assistant in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; 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.