Individual provider Active NPI

Steven Tsoutsouras, M.D., F.A.A.P.

  • Pediatrics Physician
  • Flushing, NY
National Provider Identifier
1649231184
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
141825 Issued in NY
Practice address
14645 58TH Rd
Ground Floor
Flushing, NY 11355-5416
Phone
(718) 359-5866
Fax
(178) 359-4359
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 141825 NY Primary

Addresses

Primary practice location

14645 58TH Rd
Ground Floor
Flushing, NY 11355-5416

Mailing address

14645 58TH Rd
Ground Floor
Flushing, NY 11355-5416
Phone (718) 359-5866

Other identifiers 3

IdentifierTypeStateIssuer
00609141MedicaidNY
204722183OtherNYTAX ID#
1714*01OtherNYIMMUNIZATION REGISTRY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180716001411 NY Practitioner - Pediatric Medicine 6002163540 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Aug 6, 2018 Accepting new patients
North Shore-Lij Medical PC CurrentSince Aug 6, 2018 Accepting new patients

Locations

2325 31st St
Astoria, NY 11105
Phone (516) 321-8315

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

26901 76th Ave
#102
New Hyde Park, NY 11040
Phone (718) 470-3495

27005 76th Ave
#222
New Hyde Park, NY 11040
Phone (718) 470-7260

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: stsoutsouras67879@northwell.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649231184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14645 58TH RD",
            "address_2": "GROUND FLOOR",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555416",
            "telephone_number": "718-359-5866",
            "fax_number": "178-359-4359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14645 58TH RD",
            "address_2": "GROUND FLOOR",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555416",
            "telephone_number": "718-359-5866",
            "fax_number": "178-359-4359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSOUTSOURAS",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "M.D., F.A.A.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "141825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00609141",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "204722183",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IMMUNIZATION REGISTRY",
            "identifier": "1714*01",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.