Evangeline Koutalianos, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

299948 Issued in NY

Practice address

750 E Adams St
Syracuse, NY 13210-2306

Phone

(315) 464-5820

NPI assigned

Jul 8, 2014

Last updated

May 13, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physical Medicine and Rehabilitation

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Upstate Neurosurgery LLPGroup PAC ID 0042271520, 15 clinicians

Physical Medicine and Rehab Medical Service GroupGroup PAC ID 8123911500, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241
• Upstate Medical University Inpatient rehabilitation facility, Syracuse, NY, CCN 33T241

Merit-based Incentive Payment System (MIPS)

Final score

96.72 of 100Reported as group

Quality

89.22

Promoting interoperability

100

Improvement activities

40

Cost

77.3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ekoutalianos35256@direct.upstate.edu

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.

• Physical Medicine & Rehab Medical Service Group

  • Physical Medicine & Rehabilitation Physician
  • Syracuse, NY
  • NPI 1336189919
  Medicare reassignment Care Compare group NPD
• Upstate Neurosurgery LLP

  • Neurological Surgery Physician
  • Syracuse, NY
  • NPI 1497788574
  Medicare reassignment Care Compare group NPD
• Neurosurgical Associates of Central New York, LLP

  • Durable Medical Equipment & Medical Supplies
  • Syracuse, NY
  • NPI 1346384435
  NPD

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

• Suny Health Science Center at Syracuse

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1578554630
  Care Compare affiliation
• Suny Health Science Center at Syracuse

  • Rehabilitation Hospital Unit
  • Syracuse, NY
  • NPI 1841248713

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1780090035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUTALIANOS",
        "first_name": "EVANGELINE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "299948",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NY",
            "license": "299948",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Apoorva Kotha, MD
• Barbara H. Kotz, L.C.S.W.
• Robert Alan Kotz, M.D.
• Jane Kou, MD
• Michael William Koulopoulos, MD
• George William Koutsouras, DO, MPH
• Daniel Paul Kovach, FNP
• Anastasia Kovaleva, MD
• Alexandra Kovary
• Christine Draper Kowaleski, NP

• Physical Medicine & Rehabilitation Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; 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.