Robert Koutsouvelis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

72059 Issued in TN

Practice address

917 W Walnut St
Johnson City, TN 37604-6527

Phone

(423) 439-6464

NPI assigned

Jul 21, 2021

Last updated

Oct 15, 2024By 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

Medicare fee-for-service enrollment

Enrolled in TN

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 Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Education Assistance CorporationGroup PAC ID 3870491269, 168 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063
• Franklin Woods Community Hospital Hospital, Johnson City, TN, CCN 440184

Merit-based Incentive Payment System (MIPS)

Final score

96.76 of 100Reported as apm

Quality

83.09

Promoting interoperability

99

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medical Education Assistance Corporation

  dba ETSU Physicians and Associates

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1235180480

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Medical Education Assistance Corporation

  dba University Physicians Practice Group- Etsu FM Kingsport

  • Family Medicine Physician
  • Kingsport, TN
  • NPI 1588786768
  NPD (past)

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

• Mountain States Health Alliance

  dba Woodridge Hospital

  • Psychiatric Hospital Unit
  • Johnson City, TN
  • NPI 1023434339
  Care Compare affiliation
• Mountain States Health Alliance

  dba Franklin Woods Community Hospital

  • General Acute Care Hospital
  • Johnson City, TN
  • NPI 1114033628
  Care Compare affiliation
• Mountain States Health Alliance

  dba Johnson City Medical Center

  • Psychiatric Hospital Unit
  • Johnson City, TN
  • NPI 1962915652
  Care Compare affiliation
• Mountain States Health Alliance

  dba Johnson City Medical Center

  • General Acute Care Hospital
  • Johnson City, TN
  • NPI 1972606465
  Care Compare affiliation

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1386217966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 W WALNUT ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046527",
            "telephone_number": "423-439-6464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207343",
            "country_code": "US",
            "telephone_number": "423-989-4050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 E Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603814",
            "country_code": "US",
            "telephone_number": "423-245-9600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOUTSOUVELIS",
        "first_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-21",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "72059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Selma Kominek, MD
• Sai Karthik Kommineni, MBBS
• Ashley Sheree Kono, APRN
• James Koonce, MD
• Neil W Kooy, M.D.
• Andrew A Kovacs, FNP-C
• Matthew B Kowalczyk
• Daniel E. Krenk, MD
• David Edward Kreshek, M.D.
• Koyamangalath Krishnan, MD

• Family Medicine Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.