Ekaterini Kostakos
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Essexville, MI
NPI 1801636550 · NPPES record last updated Jun 17, 2024
Key facts
- NPI
- 1801636550
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- License
- 4351053414 (MI)
- Practice address
- 1458 W Center Rd Ste 1
Essexville, MI 48732-2151 - Phone
- (989) 895-4625
- Fax
- (989) 895-4626
- NPI assigned
- May 30, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240607000425 | MI | Order and Referring Only - Family Practice |
7719429554 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 4351053414 | MI | Yes |
Addresses
Primary practice location
1458 W Center Rd Ste 1
Essexville, MI 48732-2151
Mailing address
1458 W Center Rd Ste 1
Essexville, MI 48732-2151
Phone (989) 895-4625
Other providers in Essexville, MI
- Taylor Keyes
- Abigail King
- Arturas Klugas
- Evan Koehn
- Melissa Kohner
- Olga Kostakos
- Bethany Kozielski
- Kroger Co of Michigan
- Alivia Jo Kukla
- Shaina Linn Lacasse
All providers in Essexville, MI · Student in an Organized Health Care Education/Training Program in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.