Constantinos Chrysostomou, MD

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

C129462 Issued in CA

Practice address

17360 Brookhurst Street
Attn: Network Management
Fountain Valley, CA 92708-3720

Phone

(714) 377-2900

NPI assigned

Feb 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA, TX2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: cchrysostomou532548@direct.memorialcare.org

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.

• Confermed of California PC

  • Internal Medicine Physician
  • Irvine, CA
  • NPI 1316584709
  Medicare reassignment NPD
• Memorialcare Medical Foundation

  • Clinic/Center
  • Fountain Valley, CA
  • NPI 1205167350
  Medicare reassignment
• Children'S Physician Services of South Texas

  • Plastic Surgery Physician
  • Corpus Christi, TX
  • NPI 1568658227
  Medicare reassignment
• Confermed PC

  • Internal Medicine Physician
  • Middletown, CT
  • NPI 1376190850
  NPD (past)
• Driscoll Childrens Hospital

  • Children's Hospital
  • Corpus Christi, TX
  • NPI 1548286172
  NPD (past)

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1801868658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17360 BROOKHURST STREET",
            "address_2": "ATTN: NETWORK MANAGEMENT",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083720",
            "telephone_number": "714-377-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17360 BROOKHURST STREET",
            "address_2": "ATTN: NETWORK MANAGEMENT",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083720",
            "telephone_number": "714-377-2900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13535 Nemours Pkwy",
            "address_2": "Nemours Childrens Hospital",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328277402",
            "country_code": "US",
            "telephone_number": "407-567-4000",
            "fax_number": "407-567-5924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRYSOSTOMOU",
        "first_name": "CONSTANTINOS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD426904",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "FL",
            "license": "ME126009",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "C129462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101479082",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016288000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Chow, MD
• Chris D Nagel DDS Inc
• Chris Tsimerekis, M.D., Inc.
• Rachel Christensen
• Christopher D. Liao MD, Inc.
• Yani Chu, LMFT
• Kathy Chung
• Gina Ciaramitaro, RN
• Anahin Cipriano
• Circlemed Healthcare, a Medical Corporation

• Pediatric Cardiology Physician in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Pediatric Cardiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.