Anna Poulos

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

R8811 Issued in TX

Practice address

2115 S Broadway Ave
Tyler, TX 75701-4214

Phone

(903) 907-7002

NPI assigned

Sep 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, TX2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: anna.poulos@oakstreethealth.gwaydirect.com

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.

• Oak Street Health of Texas, PLLC

  • Primary Care Clinic/Center
  • Fort Worth, TX
  • NPI 1497387419

  Internal Medicine

  Medicare reassignment NPD
• Osh Mi Physicians Group, PC

  • Primary Care Clinic/Center
  • Memphis, TN
  • NPI 1720635790
  Medicare reassignment NPD
• Oak Street Health Physicians Group of Tennessee, PLLC

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1760116172
  NPD (past)
• Oak Street Health Physicians Group, PC

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1083051643

  Internal Medicine

  NPD (past)
• Osh-Mi Physicians Group PC

  • Family Medicine Physician
  • Greensboro, NC
  • NPI 1033766092

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1689121121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746079",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746079",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014214",
            "telephone_number": "903-907-7002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3360 N Watkins St",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381276432",
            "country_code": "US",
            "telephone_number": "901-401-7150",
            "fax_number": "901-347-1285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3889 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381116634",
            "country_code": "US",
            "telephone_number": "901-401-7140",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2360 Gus Thomasson Rd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752283005",
            "country_code": "US",
            "telephone_number": "214-301-7071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4115 E Lancaster Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761033614",
            "country_code": "US",
            "telephone_number": "817-796-7370",
            "fax_number": "817-764-0714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POULOS",
        "first_name": "ANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "57800",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "175360",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R8811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Positive Hair Restoration
• Ara Potestas, PHARM D.
• Chasity Potts
• Chhabindra Poudel, MD
• Saroj Poudel
• Alyssa Powell
• Carson Lane Powell, ATC, LAT
• Christine Powell
• Emily Rachel Powell, LCSW
• Michael Edison Powell, PTA

• Internal Medicine Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.