Kosta A. Koutoulas, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

13085 Issued in CA

Practice address

7380 Mission St
Daly City, CA 94014-2666

Phone

(650) 757-8286

NPI assigned

Dec 15, 2006

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

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Kosta a. Koutoulas, OD Inc

  • Optometrist
  • Daly City, CA
  • NPI 1760295422
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1609938539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3099 RIVERA DR",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940105833",
            "telephone_number": "650-218-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7380 MISSION ST",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940142666",
            "telephone_number": "650-757-8286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUTOULAS",
        "first_name": "KOSTA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Kong
• Cindy Kong, O.D.
• Luis R Kong, D.D.S.
• Alexander Kosoff
• Kosta a. Koutoulas, OD Inc
• Kay Jiraporn Galang Kovitprakornkul, DPT
• KPC Global Medical Center of San Mateo County LLC
• KPC Global Medical Center of San Mateo County LLC
• KPC Global Medical Center of San Mateo County LLC
• KPC Global Medical Center of San Mateo County LLC

• Optometrist in Daly City, CA
• Providers in Daly City, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; 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.