NPIMap

Individual provider Active NPI

Polyxene G. Kokinos, MD

  • Specialist
  • Campbell, CA
National Provider Identifier
1679671259
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G669460 Issued in CA
Practice address
2255 S Bascom Ave
Ste 200
Campbell, CA 95008-7800
Phone
(408) 376-3626
Fax
(408) 871-2377
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G669460 CA Primary

Addresses

Primary practice location

2255 S Bascom Ave
Ste 200
Campbell, CA 95008-7800

Mailing address

2255 South Bascom Avenue
Ste 200
Campbell, CA 95008
Phone (408) 376-3626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060112000913 CA Practitioner - Vascular SurgeryPractitioner - Emergency MedicinePractitioner - Other (Physician) 5991728198 Reassigns benefits to 2 organizations
Receives reassigned benefits from 2 practitioners
Practice locations: Campbell, CA

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Columbia University College of Physicians and Surgeons, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Polyxene Gazetas Kokinos MD PCGroup PAC ID 0244652386, 5 clinicians

Practice addresses (Care Compare)

2255 S Bascom Ave
Campbell, CA 95008-7800
Phone (408) 376-3626

8420 Church St
Gilroy, CA 95020-4229
Phone (408) 376-3626

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal164
Leg revascularization (restoring blood flow)130
Removal of tissue61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G669460CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Polyxene Gazetas Kokinos MD PC CurrentSince Apr 1, 2020 Accepting new patients
Institute for Vascular Testing Current Accepting new patients
Institute for Vascular Testing CurrentSince Jan 1, 2014 Accepting new patients
Spine & Sports Medical Group Inc Past Accepting new patients
El Camino Health Medical Network, LLC Past Accepting new patients
El Camino Hospital Past Accepting new patients
El Camino Hospital Past Accepting new patients
County of Santa Clara Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
County of Santa Clara Past Accepting new patients

Locations

2255 S Bascom Ave
Ste 200
Campbell, CA 95008
Phone (408) 376-3626

8420 Church St
Gilroy, CA 95020
Phone (408) 376-3626

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: pkokinos125784@santaclaravalley.direct-ci.net

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 11

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1679671259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 SOUTH BASCOM AVENUE",
            "address_2": "STE 200",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "95008",
            "telephone_number": "408-376-3626",
            "fax_number": "408-871-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 S BASCOM AVE",
            "address_2": "STE 200",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950087800",
            "telephone_number": "408-376-3626",
            "fax_number": "408-871-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOKINOS",
        "first_name": "POLYXENE",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G669460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

Verify at the official NPI Registry.