Marie S Kourtelidis, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

RN205733 Issued in MA

Practice address

850 Harrison Ave
Yawkey 4TH Floor
Boston, MA 02118-4001

Phone

(617) 414-2000

Fax

(617) 414-5798

NPI assigned

Dec 19, 2005

Sex

Female

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 MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkourtelidis10915@direct.bmc.masshiway.net

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.

• Boston University Obstetrics and Gynecology Foundation, Inc.

  • Obstetrics & Gynecology Physician
  • Boston, MA
  • NPI 1063459568
  Medicare reassignment NPD
• Boston Medical Center Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1346218294
  NPD

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399334400000",
    "number": "1649256017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVE",
            "address_2": "YAWKEY 4TH FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184001",
            "telephone_number": "617-414-2000",
            "fax_number": "617-414-5798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOURTELIDIS",
        "first_name": "MARIE",
        "middle_name": "S",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2014-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MA",
            "license": "RN205733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110015811A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christos Koumoutseas
• Dylan Charles Koundakjian, MD
• Lauren Marie Koup, PA-C
• Stella Kourembanas, MD
• Arianne Kourosh, MD
• Polyxeni D Koutkia, MD
• Nicholas Emmanuel Koutrakis, DDS
• Andrei Kouznetsov, MD
• Victor Kovac, MD
• Alexandra E Kovach, M.D.

• Advanced Practice Midwife in Boston, MA
• Providers in Boston, MA by specialty
• Advanced Practice Midwife in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.