NPIMap

Individual provider Active NPI

Kristina Goutsouliak, MD

  • Medical Oncology Physician
  • Grand Junction, CO
National Provider Identifier
1447690938
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
DR.0061682 Issued in CO
Practice address
2596 F Rd
Grand Junction, CO 81505-1443
Phone
(970) 254-3180
Fax
(970) 254-3198
NPI assigned
Jun 27, 2013
Last updated
Jul 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X DR.0061682 CO
Medical Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RX0202X DR.0061682 CO Primary

Addresses

Primary practice location

2596 F Rd
Grand Junction, CO 81505-1443

Mailing address

PO Box 1727
Grand Junction, CO 81502-1727
Phone (970) 263-2619

Other practice location 1

100 E Lancaster Ave
Wynnewood, PA 19096-3450
Phone (484) 476-6843

Other practice location 2

2351 G Rd
Grand Junction, CO 81505-9641
Phone (970) 254-3180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190816001024 CO Practitioner - Medical OncologyPractitioner - Internal MedicinePractitioner - Hematology/Oncology 2466789227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Hematology/Oncology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Colorado West Healthcare SystemGroup PAC ID 3971491887, 35 clinicians

Practice addresses (Care Compare)

2596 F Rd
Grand Junction, CO 81505-1443
Phone (970) 254-3180

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
40.82 of 100Reported as group
Quality
9.1
Promoting interoperability
100
Improvement activities
0
Cost
43.64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado West Healthcare System Multi-Specialty Current Accepting new patients
Colorado West Healthcare System Multi-Specialty CurrentSince Jul 19, 2019 Accepting new patients
Colorado West Healthcare System CurrentSince Jul 19, 2019 Accepting new patients
Community Medical Group, LLC Multi-Specialty Past Accepting new patients

Locations

2351 G Rd
Grand Junction, CO 81505
Phone (970) 242-0920

688 23 12 Rd Ste 201
Ste 201
Grand Junction, CO 81505

Organizations & group practices 4

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1447690938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1727",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815021727",
            "telephone_number": "970-263-2619",
            "fax_number": "970-263-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2596 F RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051443",
            "telephone_number": "970-254-3180",
            "fax_number": "970-254-3198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Lancaster Ave",
            "address_purpose": "LOCATION",
            "city": "Wynnewood",
            "state": "PA",
            "postal_code": "190963450",
            "country_code": "US",
            "telephone_number": "484-476-6843",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2351 G Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815059641",
            "country_code": "US",
            "telephone_number": "970-254-3180",
            "fax_number": "970-254-3198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOUTSOULIAK",
        "first_name": "KRISTINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-27",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CO",
            "license": "DR.0061682",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "CO",
            "license": "DR.0061682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.