Philip D. Kousoubris, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

160515 Issued in MA

Practice address

11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349

Phone

(952) 595-1301

Fax

(612) 294-4903

NPI assigned

Sep 22, 2006

Last updated

Mar 16, 2022By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA, AZ2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

Jefferson Medical College of Thomas Jefferson University, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physicians of Cape Cod HospitalGroup PAC ID 9638326671, 330 clinicians

Southwest Diagnostic Imaging LLCGroup PAC ID 7416946199, 121 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cape Cod Hospital Hospital, Hyannis, MA, CCN 220012
• Brigham and Women's Hospital Hospital, Boston, MA, CCN 220110
• Falmouth Hospital Hospital, Falmouth, MA, CCN 220135

Merit-based Incentive Payment System (MIPS)

Final score

84.3 of 100Reported as group

Quality

71.45

Promoting interoperability

100

Improvement activities

40

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.

• Physicians of Cape Cod Hospital

  • Neuroradiology Physician
  • Hyannis, MA
  • NPI 1679832364
  Medicare reassignment Care Compare group NPD
• Southwest Diagnostic Imaging LLC

  • Diagnostic Radiology Physician
  • Scottsdale, AZ
  • NPI 1902896236

  MA, Neuroradiology

  Medicare reassignment Care Compare group NPD
• Fred Smeltzer MD & Associates Inc

  dba Lake of the Ozarks Radiology

  • Diagnostic Radiology Physician
  • Osage Beach, MO
  • NPI 1639122286

  MA

  Medicare reassignment NPD
• Lahey Clinic, Inc

  • Internal Medicine Physician
  • Peabody, MA
  • NPI 1063447316
  Medicare reassignment NPD
• North Georgia Radiology

  • Specialist
  • Dalton, GA
  • NPI 1922193044

  MA

  Medicare reassignment NPD
• Radiologists of Cape Cod Hospital

  • Diagnostic Radiology Physician
  • Hyannis, MA
  • NPI 1073240586
  Medicare reassignment NPD
• Sonoran Radiology LTD

  • Vascular & Interventional Radiology Physician
  • Mesa, AZ
  • NPI 1033745708

  Diagnostic Radiology, MA

  Medicare reassignment NPD
• Bryn Mawr Imaging

  • Diagnostic Radiology Physician
  • Bryn Mawr, PA
  • NPI 1457351314
  NPD (past)
• Coolidge Corner Imaging, LLC

  • Diagnostic Radiology Physician
  • Brookline, MA
  • NPI 1043364920
  NPD (past)
• Main Line Health Imaging LP

  • Diagnostic Radiology Physician
  • Wynnewood, PA
  • NPI 1477504264
  NPD (past)
• Main Line Health Imaging LP

  • Body Imaging Physician
  • Wynnewood, PA
  • NPI 1598951592
  NPD (past)
• Massachusetts Eye and Ear Associates, Inc.

  • Ophthalmology Physician
  • Boston, MA
  • NPI 1932574332

  Diagnostic Radiology

  NPD (past)

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

• Brigham & Womens Hospital, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1790717650
  Care Compare affiliation
• Cape Cod Hospital Inc

  dba Cape Cod Hospital

  • General Acute Care Hospital
  • Hyannis, MA
  • NPI 1114984671
  Care Compare affiliation
• Falmouth Hospital Association Inc

  • General Acute Care Hospital
  • Falmouth, MA
  • NPI 1336106806
  Care Compare affiliation

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1447350442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018055349",
            "country_code": "US",
            "telephone_number": "781-744-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOUSOUBRIS",
        "first_name": "PHILIP",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "160515",
            "primary": true
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MA",
            "license": "160515",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdurahman Dahir Koshin
• Anna M Kostanecka, M.D.
• Chad Martin Koterba, D.C., A.T.C.
• Zoe A Kothlow
• Melinda Kounthapanya, PHARM.D.
• Dustin Anthony Kovach, PA-C
• Joseph L Kovar, M.D.
• Eric Joseph Kraemer, MD
• Madison E Krage
• Meredith Francis Kramer, COTA/L, IBCLC, LCCE

• Diagnostic Radiology Physician in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Diagnostic Radiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.