Individual provider Active NPI

Stephen T. Kouri, M.D.

  • Anesthesiology Physician
  • Long Beach, CA
National Provider Identifier
1871577106
Registry record updated Mar 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G75403 Issued in CA
Practice address
1720 Termino Ave
Long Beach, CA 90804-2104
Phone
(562) 498-1000
NPI assigned
Nov 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G75403 CA Primary

Addresses

Primary practice location

1720 Termino Ave
Long Beach, CA 90804-2104

Mailing address

210 N Tustin Ave
Santa Ana, CA 92705-3807
Phone (800) 883-7243

Other identifiers 1

IdentifierTypeStateIssuer
00G754031MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20060717000211 CA Practitioner - Anesthesiology 1153334180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Hahnemann University College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perioperative Anesthesia ConsultantsGroup PAC ID 1658779632, 8 clinicians

Practice addresses (Care Compare)

1127 Wilshire Blvd
Suite 1000 10TH Floor
Los Angeles, CA 90017-3901
Phone (213) 328-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G75403CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Perioperative Anesthesia Consultants Anesthesiology CurrentSince Aug 1, 2022 Accepting new patients

Locations

1127 Wilshire Blvd
Ste 1000
Los Angeles, CA 90017
Phone (213) 328-3600

6801 Park Ter
Ste 300
Los Angeles, CA 90045
Phone (310) 655-7200

3445 Pacific Coast Hwy
Ste 110
Torrance, CA 90505
Phone (310) 325-4555

3445 Pacific Coast Hwy
Ste 120
Torrance, CA 90505
Phone (310) 325-4555

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300060800000",
    "number": "1871577106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "800-883-7243",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 TERMINO AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042104",
            "telephone_number": "562-498-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOURI",
        "first_name": "STEPHEN",
        "middle_name": "T.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2011-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G75403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G754031",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.