Lidia B Koulova, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

234815 Issued in NY

Practice address

70 Hatfield LN
Suite 101
Goshen, NY 10924-6734

Phone

(845) 294-8888

Fax

(845) 294-1669

NPI assigned

Jan 12, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

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

HematologyAlso: Hematology/Oncology, Internal Medicine

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bon Secours Charity Health System Medical Group, P.C.Group PAC ID 1658262084, 157 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Anthony Community Hospital Hospital, Warwick, NY, CCN 330205
• Garnet Health Medical Center Hospital, Middletown, NY, CCN 330126
• Bon Secours Community Hospital Hospital, Port Jervis, NY, CCN 330135
• Good Samaritan Hospital of Suffern Hospital, Suffern, NY, CCN 330158
• Montefiore St Luke'S Cornwall Hospital, Newburgh, NY, CCN 330264

Merit-based Incentive Payment System (MIPS)

Final score

96.73 of 100Reported as apm

Quality

87.82

Promoting interoperability

92

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

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.

• Bon Secours Charity Health System Medical Group, P.C.

  • Internal Medicine Physician
  • Warwick, NY
  • NPI 1487694345
  Medicare reassignment Care Compare group NPD

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

• Bon Secours Community Hospital

  • General Acute Care Hospital
  • Port Jervis, NY
  • NPI 1659360709
  Care Compare affiliation
• Garnet Health Medical Center

  • General Acute Care Hospital
  • Middletown, NY
  • NPI 1609875772
  Care Compare affiliation
• Good Samaritan Hospital of Suffern

  • General Acute Care Hospital
  • Suffern, NY
  • NPI 1346213469
  Care Compare affiliation
• St. Anthony Community Hospital

  • General Acute Care Hospital
  • Warwick, NY
  • NPI 1598755324
  Care Compare affiliation
• St. Luke'S Cornwall Hospital

  • General Acute Care Hospital
  • Newburgh, NY
  • NPI 1003923434
  Care Compare affiliation

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1467431999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GRAND ST",
            "address_2": "3RD FL",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109901035",
            "telephone_number": "845-294-8888",
            "fax_number": "845-987-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 HATFIELD LN",
            "address_2": "SUITE 101",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109246734",
            "telephone_number": "845-294-8888",
            "fax_number": "845-294-1669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOULOVA",
        "first_name": "LIDIA",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-12",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "234815",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "234815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02638984",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00244709",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bridget A Kolka
• Susan Konitsky, LPN
• Irina V Koreen, MD, PHD
• Kristy Lynn Kosior
• Katelynn Marie Kostro
• Raymond Edward Kozireski Jr.
• Christy Krawczyk, LCSW
• Christy C Kriney, LCSW R
• Kris-Tal Corp
• Felicia Kruithof, LAC

• Hematology & Oncology Physician in Goshen, NY
• Providers in Goshen, NY by specialty
• Hematology & Oncology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.