Active NPI
Ghassan Jamil Koussa, M.D.
- Pulmonary Disease Physician
- Oneida, NY
National Provider Identifier
1730341421
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- T9727
- Practice address
- 600 Seneca St
Oneida, NY 13421-2668 - Phone
- (315) 361-7472
- Fax
- (315) 361-7473
- NPI assigned
- Jun 25, 2008
- Last updated
- Nov 1, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 16076 | NH | |
| Pulmonary Disease Physician | 207RP1001X | 16076 | NH | |
| Pulmonary Disease Physician | 207RP1001X | T9727 | TX | Primary |
Addresses
Primary practice location
600 Seneca St
Oneida, NY 13421-2668
Mailing address
600 Seneca St
Oneida, NY 13421-2668
Phone (315) 361-7472
Other practice location 1
35 Riverside Dr
Utica, NY 13502-2320
Phone (315) 735-2294
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04598138 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
600 Seneca St
Oneida, NY 13421-2668
Phone (315) 361-7472
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16076 | NH | MD | Critical Care Medicine (Internal Medicine) Physician |
| T9727 | TX | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MVHS Inc | Current | Accepting new patients | |
| MVHS Inc | Current | Accepting new patients |
Locations
1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222
1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567
2209 Genesee St
Ofc
Utica, NY 13501
Phone (315) 801-3282
35 Riverside Dr
Utica, NY 13502
Phone (315) 624-8400
Interoperability endpoints
- gkoussa@ompohc.medentdirect.com
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Oneida, NY
- NPI 1932398997
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Oneida Healthcare Center
- General Acute Care Hospital
- Oneida, NY
- NPI 1962408203
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667260800000",
"number": "1730341421",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 SENECA ST",
"city": "ONEIDA",
"state": "NY",
"postal_code": "134212668",
"telephone_number": "315-361-7472",
"fax_number": "315-361-7473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 SENECA ST",
"city": "ONEIDA",
"state": "NY",
"postal_code": "134212668",
"telephone_number": "315-361-7472",
"fax_number": "315-361-7473"
}
],
"practiceLocations": [
{
"address_1": "35 Riverside Dr",
"address_purpose": "LOCATION",
"city": "Utica",
"state": "NY",
"postal_code": "135022320",
"country_code": "US",
"telephone_number": "315-735-2294",
"fax_number": "315-735-2021",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOUSSA",
"first_name": "GHASSAN",
"middle_name": "JAMIL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-25",
"last_updated": "2022-11-01",
"certification_date": "2022-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "NH",
"license": "16076",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NH",
"license": "16076",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "TX",
"license": "T9727",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04598138",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oneida, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.