Konan Eugene Kouassi, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005325 Issued in MI

Practice address

23077 Greenfield Rd
Ste 485
Southfield, MI 48075

Phone

(248) 552-9050

Fax

(248) 552-1290

NPI assigned

Apr 15, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beaumont Medical Group Hospital Based ServicesGroup PAC ID 3072875889, 575 clinicians

Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151
• Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302
• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkouassi@direct.dmc.org
• Direct secure messaging: kkouassi13681@direct.hfhs.org

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.

• Henry Ford Health System

  • Physician Assistant
  • Detroit, MI
  • NPI 1811073901
  Medicare reassignment Care Compare group NPD
• Beaumont Medical Group Hospital -Based Services

  • Hospitalist Physician
  • Royal Oak, MI
  • NPI 1427567858
  Medicare reassignment Care Compare group
• Oakwood Ambulatory LLC

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1003829441
  Medicare reassignment NPD
• Pioneer Medical Group PLLC

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1801304688
  Medicare reassignment
• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD
• Downriver ENT PC

  • Clinic/Center
  • Allen Park, MI
  • NPI 1134304595
  NPD (past)
• Henry Ford Maplegrove Center

  • Children's Substance Abuse Rehabilitation Facility
  • West Bloomfield, MI
  • NPI 1295767630
  NPD (past)
• Melvin C. Murphy, M.D. P.C.

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1962693960
  NPD (past)

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

• Botsford General Hospital

  • Podiatrist
  • Farmington Hills, MI
  • NPI 1093828303

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Family Medicine Physician
  • Dearborn Heights, MI
  • NPI 1114935566

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • General Acute Care Hospital
  • Farmington Hills, MI
  • NPI 1336183367
  Care Compare affiliation
• Botsford General Hospital

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1538103395

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Family Medicine Physician
  • Farmington Hills, MI
  • NPI 1871521153

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1871907303

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1912335373

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Pulmonary Disease Physician
  • Farmington Hills, MI
  • NPI 1912915349

  Hospital

  Care Compare affiliation
• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation
• Henry Ford Health System

  • General Acute Care Hospital
  • West Bloomfield, MI
  • NPI 1407867559
  Care Compare affiliation

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1477879492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 CHRISTOPHER LN APT 318",
            "city": "KEEGO HARBOR",
            "state": "MI",
            "postal_code": "483201352",
            "telephone_number": "313-283-8258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23077 GREENFIELD RD",
            "address_2": "STE 485",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48075",
            "telephone_number": "248-552-9050",
            "fax_number": "248-552-1290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28050 Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483365919",
            "country_code": "US",
            "telephone_number": "947-521-8196",
            "fax_number": "248-471-8896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOUASSI",
        "first_name": "KONAN",
        "middle_name": "EUGENE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-15",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477879492",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwillner365576@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "2799 W Grand Blvd",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482022608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ayesha Kothari, MD
• Magdalena Agnieszka Kotlarz, PA-C
• Ana Marie Kotsogiannis, CRNA
• Atara Kott
• Krista Kotzeva, D.P.M.
• Zahraa Kourani
• Madison Kowalewski, OTR/L
• Elizabeth Kowynia, PA-C
• Benita Koyton, LMSW
• Cassandra Katlyn Kozan

• Physician Assistant in Southfield, MI
• Providers in Southfield, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.