Konstantinos Koutros, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

162441 Issued in NY

Practice address

9101 4TH Ave Suite 1R
9101 4TH Ave Suite 1R
Brooklyn, NY 11209

Phone

(718) 745-0707

Fax

(718) 745-0412

NPI assigned

Aug 29, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Guild for Exceptional Children, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Brooklyn, NY
  • NPI 1740231836
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1639288327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 4TH AVE SUITE 1R",
            "address_2": "9101 4TH AVE SUITE 1R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11209",
            "telephone_number": "718-745-0707",
            "fax_number": "718-745-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 4TH AVE SUITE 1R",
            "address_2": "9101 4TH AVE SUITE 1R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11209",
            "telephone_number": "718-745-0707",
            "fax_number": "718-745-0412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUTROS",
        "first_name": "KONSTANTINOS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "162441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00961019",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michele Koury, LMHC
• Alena Kourzanov, RN
• Konstantinos Koutelos, M.D.
• Thomas N Koutelos, INTERNAL MEDICINE
• Andreas Koutras, MD
• Stella Koutsakis-Rallakis, RN
• Kathy Tina Koutsianas
• Haroula Harriet Koutsivitis, MA, CCC-SLP
• Markos I. Koutsos, M.D.
• Brette Koutsoukos, M.S.ED

• Internal Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.