Sean Koulaboud, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95004148 Issued in CA

Practice address

1600 Creekside Dr Ste 2100
Folsom, CA 95630-3447

Phone

(169) 832-6639

Fax

(169) 830-6029

NPI assigned

Dec 7, 2015

Last updated

May 3, 2018By 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 3

Addresses

Other identifiers 2

Other names 1

• Sean Koulaboud Professional name

Medicare fee-for-service enrollment

Enrolled in CA

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

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sean.koulaboud.1@29879.direct.athenahealth.com
• Direct secure messaging: skoulaboud12929@hpmg.direct-ci.net

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.

• Caliboud Nursing Solutions, Inc.

  • Family Nurse Practitioner
  • Rocklin, CA
  • NPI 1821846635
  Medicare reassignment NPD Authorized official
• Carepoint Hospital Medicine Kansas LLC

  • Hospitalist Physician
  • Wichita, KS
  • NPI 1588234249
  NPD (past)

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

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525305600000",
    "number": "1568837276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 CREEKSIDE DR STE 2100",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303447",
            "telephone_number": "169-832-6639",
            "fax_number": "169-830-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CREEKSIDE DR STE 2100",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303447",
            "telephone_number": "169-832-6639",
            "fax_number": "169-830-6029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 N Hillside St",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672144910",
            "country_code": "US",
            "telephone_number": "316-962-2000",
            "fax_number": "303-306-7753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOULABOUD",
        "first_name": "SEAN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-07",
        "last_updated": "2018-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "APRN-53-76899",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-76899",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95004148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS NURSING LICENSE",
            "identifier": "APRN-53-76899",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA NURSING LICENSE",
            "identifier": "95004148",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SEAN",
            "last_name": "KOULABOUD",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Elizabeth Joanne Koontz
• Robert B Kopitzke, P.T.
• Norbert G Korp, D.M.D.
• Julia Korsunsky, NP
• Florence Kathleen Kotze, OTRIL CHT
• William Frederick Kramer, D.O.
• Andreas Kraus, LMFT
• Kirsten Kraus
• Elizabeth Krauss
• Jennifer Krebsbach, M.S.

• Family Nurse Practitioner in Folsom, CA
• Providers in Folsom, CA by specialty
• Family Nurse Practitioner in California

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