Individual provider Active NPI

Peter Konou, PA-C

  • Physician Assistant
  • Tallahassee, FL
National Provider Identifier
1902613078
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1300 Miccosukee Rd
Tallahassee, FL 32308-5054
Phone
(850) 431-1155
NPI assigned
Dec 12, 2024
Last updated
Dec 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1300 Miccosukee Rd
Tallahassee, FL 32308-5054

Mailing address

709 Mall Blvd
Savannah, GA 31406-4805

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250516002747 FL Practitioner - Physician Assistant 2961920525 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1300 Miccosukee Rd
Tallahassee, FL 32308-5054
Phone (850) 431-1155

1401 Centerville Rd
Tallahassee, FL 32308-4639

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
TMH Emergency Physician Group CurrentSince Jun 1, 2025 Accepting new patients
Tallahassee Memorial Healthcare Inc CurrentSince Jun 1, 2025 Accepting new patients

Locations

1260 Metropolitan Blvd
Tallahassee, FL 32312
Phone (850) 422-5413

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

1401 Centerville Rd
Ste 400
Tallahassee, FL 32308
Phone (850) 431-3360

1607 Saint James Ct
Ste 1
Tallahassee, FL 32308
Phone (850) 431-7021

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1902613078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 MALL BLVD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MICCOSUKEE RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085054",
            "telephone_number": "850-431-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONOU",
        "first_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.