NPIMap

Individual provider Active NPI

Samira Karakossian, MD

  • Family Medicine Physician
  • Port Orange, FL
National Provider Identifier
1710114780
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME111215 Issued in FL
Practice address
3801 Woodbriar TRL
Port Orange, FL 32129-9627
Phone
(386) 382-7177
NPI assigned
Jun 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME111215 FL Primary

Addresses

Primary practice location

3801 Woodbriar TRL
Port Orange, FL 32129-9627

Mailing address

PO Box 612
New Smyrna Beach, FL 32170-0612
Phone (386) 382-7177

Other identifiers 1

IdentifierTypeStateIssuer
00661300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20131220000529 FL Practitioner - Family Practice 8921235854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Florida College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

3801 Woodbriar TRL
Port Orange, FL 32129-9627
Phone (386) 382-7177

Hospital & facility affiliations

  • Halifax Health Care at Home Home health agency, Port Orange, FL, CCN 108359
  • Trilogy Home Healthcare Home health agency, Jacksonville, FL, CCN 107689
  • Brooks Rehabilitation Home Health Home health agency, Daytona Beach, FL, CCN 107628
  • Adventhealth Home Health Home health agency, Ormond Beach, FL, CCN 107408
  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
  • Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017
  • Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME111215FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr K Primary Care, LLC Family Medicine CurrentSince Mar 17, 2022 Accepting new patients

Locations

3801 Woodbriar Trl
Port Orange, FL 32129
Phone (386) 382-7177

Interoperability endpoints

  • Direct secure messaging: samira.karakossian.1@25560.direct.athenahealth.com

Organizations & group practices 1

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 9

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": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1710114780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 612",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321700612",
            "telephone_number": "386-382-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 WOODBRIAR TRL",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321299627",
            "telephone_number": "386-382-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARAKOSSIAN",
        "first_name": "SAMIRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME111215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00661300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

Verify at the official NPI Registry.