Angie Koriakos, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

P3746 Issued in TX

Practice address

399 W Campbell Rd Ste 410
Richardson, TX 75080-3636

Phone

(972) 469-3376

Fax

(972) 469-3288

NPI assigned

Mar 30, 2010

Last updated

Jan 17, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Dermatology

Education

Western University of Health Sciences College of Dental Med, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

K Dermatology PLLCGroup PAC ID 6103105432, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• K Dermatology PLLC

  dba K Dermatology & Wellness Institute

  • Dermatology Physician
  • Richardson, TX
  • NPI 1386195204
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1396060794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 W CAMPBELL RD STE 410",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803636",
            "telephone_number": "972-469-3376",
            "fax_number": "972-469-3288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 W CAMPBELL RD STE 410",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803636",
            "telephone_number": "972-469-3376",
            "fax_number": "972-469-3288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORIAKOS",
        "first_name": "ANGIE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-30",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "20A12095",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "P3746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Koltun
• Joshua Kong, MD
• Dora M Kopoi
• Lawrence Jay Korenman, D.D.S.
• Kori Kind Helpers LLC
• Karen D Kornelsen, LPC INTERN
• Divya Korrapati
• McKenzie Marie Koshi
• Suja Koshy, PTA
• Khaled Kotb

• Dermatology Physician in Richardson, TX
• Providers in Richardson, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; 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.