Agathoklis Konstantinidis, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD456025 Issued in PA

Practice address

1020 Baltimore Pike Ste 220
Glen Mills, PA 19342-1372

Phone

(610) 627-4427

NPI assigned

Mar 20, 2011

Last updated

Jan 9, 2024By 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 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY, PA2 enrollments

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 2

Specialty

General Surgery

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
• Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: akonstantinidis142736@direct-guthrie.org

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643

  Surgery

  Medicare reassignment Care Compare group NPD
• Guthrie Medical Group, P.C.

  • Family Medicine Physician
  • Athens, PA
  • NPI 1962451153
  Medicare reassignment NPD
• Guthrie Medical Group, P.C.

  • Multi-Specialty Clinic/Center
  • Corning, NY
  • NPI 1134178635
  Medicare reassignment NPD
• Guthrie Medical Group, P.C.

  • Surgery Physician
  • Sayre, PA
  • NPI 1083666275
  NPD
• Guthrie Medical Group, P.C.

  • General Practice Physician
  • Sayre, PA
  • NPI 1245246644
  NPD
• Riddle Memorial Hospital

  • General Acute Care Hospital
  • Media, PA
  • NPI 1407856099
  NPD (past)

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

• Main Line Hospitals, Inc.

  dba Lankenau Hospital

  • General Acute Care Hospital
  • Wynnewood, PA
  • NPI 1245335629
  Care Compare affiliation
• Riddle Memorial Hospital

  • General Acute Care Hospital
  • Media, PA
  • NPI 1407856099
  Care Compare affiliation

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

{
    "created_epoch": "1300579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1578862348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 BALTIMORE PIKE STE 220",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421372",
            "telephone_number": "610-627-4427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 BALTIMORE PIKE STE 220",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421372",
            "telephone_number": "610-627-4427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5419 N Lovington Hwy Ste 4",
            "address_purpose": "LOCATION",
            "city": "Hobbs",
            "state": "NM",
            "postal_code": "882409102",
            "country_code": "US",
            "telephone_number": "575-392-3200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1115 Cordova St Apt 302",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911063031",
            "country_code": "US",
            "telephone_number": "626-376-6916",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5419 N Lovington Hwy Ste 4",
            "address_purpose": "LOCATION",
            "city": "Hobbs",
            "state": "NM",
            "postal_code": "882409102",
            "country_code": "US",
            "telephone_number": "575-392-3200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Guthrie Dr",
            "address_purpose": "LOCATION",
            "city": "Corning",
            "state": "NY",
            "postal_code": "148303696",
            "country_code": "US",
            "telephone_number": "626-376-6916",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 Center Way",
            "address_purpose": "LOCATION",
            "city": "Corning",
            "state": "NY",
            "postal_code": "14830",
            "country_code": "US",
            "telephone_number": "607-936-9971",
            "fax_number": "607-962-8938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONSTANTINIDIS",
        "first_name": "AGATHOKLIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-20",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "297325",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NM",
            "license": "MD2016-0905",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD456025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akonstantinidis142736@direct-guthrie.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1 Guthrie Dr",
            "city": "Corning",
            "state": "NY",
            "country_code": "US",
            "postal_code": "148303696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Julia N Kleckner, PHARMD
• Barbara Cheyney Knickerbocker, PHD
• Angela Koehler
• Alia Koertner
• Rachel Kokos
• Jason Paul Kopec, M.S., ATC
• Elizabeth Lucina Koprich
• Deron Todd Kovac, D.M.D.
• Michael A Krafchick, DO
• Jonathan R Kropf, D.C.

• Surgery Physician in Glen Mills, PA
• Providers in Glen Mills, PA by specialty
• Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; 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.