Wassil Mohamed Kouba

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

240 Meeting House Lane Medical Education Department
Southampton, NY 11968

Phone

(631) 723-6141

NPI assigned

Apr 9, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: wkouba22811@prd.direct.tbh.org

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

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1528852837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MEETING HOUSE LANE MEDICAL EDUCATION DEPARTMENT",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "11968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MEETING HOUSE LANE MEDICAL EDUCATION DEPARTMENT",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "11968",
            "telephone_number": "631-723-6141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUBA",
        "first_name": "WASSIL",
        "middle_name": "MOHAMED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-09",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Kolarik
• Joanna Komoska, LCSW
• Lauryn Korsakas, NP
• Mark Robert Kot, M.D.
• Jesse Nicole Kotler
• Romina Isabel Kramer, OTR/L
• Peggy Karen Kraus, CDE. RCEP
• Beth Crosby Kriegsman, CNM
• Nayun Kwon
• Veronica Ellen Kyrk

• Student in an Organized Health Care Education/Training Program in Southampton, NY
• Providers in Southampton, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.