Stephanie Kouvatsos, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110007996 Issued in VA

Practice address

3742 Winterfield Rd
Midlothian, VA 23113-9230

Phone

(804) 330-3335

Fax

(804) 320-2717

NPI assigned

Jun 6, 2021

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 VA, FL2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Aldrich Cardiovascular InstituteGroup PAC ID 5597796664, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087
• Lakewood Ranch Medical Center Hospital, Bradenton, FL, CCN 100299

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Aldrich Cardiovascular Institute

  • Cardiovascular Disease Physician
  • Lakewood Ranch, FL
  • NPI 1184614851
  Medicare reassignment Care Compare group
• Advanced Pain Management Inc

  • Interventional Pain Medicine Physician
  • Stoneham, MA
  • NPI 1770685877
  NPD (past)

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

• Lakewood Ranch Medical Center

  • General Acute Care Hospital
  • Bradenton, FL
  • NPI 1730179714
  Care Compare affiliation
• Sarasota County Public Hospital District

  • General Acute Care Hospital
  • Sarasota, FL
  • NPI 1245294826
  Care Compare affiliation

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

{
    "created_epoch": "1622937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1801463112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3742 WINTERFIELD RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231139230",
            "telephone_number": "804-330-3335",
            "fax_number": "804-320-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3742 WINTERFIELD RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231139230",
            "telephone_number": "804-330-3335",
            "fax_number": "804-320-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUVATSOS",
        "first_name": "STEPHANIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-06",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110007996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mabinty NMN Koker, RN
• Taylor Kotait, MSW, SISW
• Lisa Kotasek
• Kellie Michelle Kouri, MPT
• George A Koussoglou, LCSW
• Madison Rea Kozeniesky, PA-C
• Andrew John Kozusko
• Kaylyn Krauss, PT, DPT
• Annamuthu Krishna, M.D
• Kroger Limited Partnership I

• Medical Physician Assistant in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.

Verify at the official NPI Registry.