Lisa Marie Koumoulos, APN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NJ01081600 Issued in NJ

Practice address

92 Summit Ave
Hackensack, NJ 07601-1263

Phone

(201) 342-0066

NPI assigned

Dec 4, 2020

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

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Excelcare Medical Associates PAGroup PAC ID 4284647868, 200 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
• Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008
• Valley Hospital Hospital, Paramus, NJ, CCN 310012

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lisa.marie.koumoulos.1@22331.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Excelcare Medical Associates, PA

  • Internal Medicine Physician
  • Teaneck, NJ
  • NPI 1992736300
  Medicare reassignment Care Compare group NPD
• North Jersey Internal Medicine PC

  • Internal Medicine Physician
  • Hackensack, NJ
  • NPI 1114027885
  Medicare reassignment NPD

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

• HMH Hospitals Corporation

  dba Hackensack University Medical Center

  • General Acute Care Hospital
  • Hackensack, NJ
  • NPI 1457456279
  Care Compare affiliation
• HMH Hospitals Corporation

  dba Hackensack Meridian Diagnostic Laboratory

  • Clinical Medical Laboratory
  • Hackensack, NJ
  • NPI 1518683929

  Hospital

  Care Compare affiliation
• Holy Name Hospital Regional Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Teaneck, NJ
  • NPI 1043389349

  Hospital

  Care Compare affiliation
• Holy Name Medical Center Inc.

  • General Acute Care Hospital
  • Teaneck, NJ
  • NPI 1104859131
  Care Compare affiliation
• The Valley Hospital Inc.

  • General Acute Care Hospital
  • Paramus, NJ
  • NPI 1013912633
  Care Compare affiliation

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1700482866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD",
            "address_2": "BLDG 2, STE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 SUMMIT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011263",
            "telephone_number": "201-342-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUMOULOS",
        "first_name": "LISA MARIE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-04",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ01081600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dejan Koskoski, DPT
• Ian Dennis Kosovsky, DMD
• Lahari Kota, MD
• Lisa Anne Kotler, MD
• Heidi Koukourdelis, RPH
• Ashley Kourgialis, PA-C
• Timothy S Kowal, MD
• Rachel Kowalenko, LCSW
• Caroline Kozek, APN
• Jeffrey Joseph Kraft, M.D.

• Adult Health Nurse Practitioner in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.