NPIMap

Individual provider Active NPI

Socrates C. Jamoulis, MD

  • Diagnostic Radiology Physician
  • Kansas City, MO
National Provider Identifier
1912980194
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
143388 Issued in MO
Practice address
9501 N Oak Trfy
#100
Kansas City, MO 64155-2256
Phone
(816) 455-0661
Fax
(816) 454-1080
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 143388 MO Primary
Diagnostic Radiology Physician 2085R0202X 23369 KS

Addresses

Primary practice location

9501 N Oak Trfy
#100
Kansas City, MO 64155-2256

Mailing address

PO Box 414975
Kansas City, MO 64141-4975
Phone (816) 455-0661

Other identifiers 4

IdentifierTypeStateIssuer
204795108MedicaidMO
2267634OtherAETNA
100124320CMedicaidKS
26323071OtherMOBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23369KSMDDiagnostic Radiology Physician
143388MOMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Health Physicians Past Accepting new patients
Northland Imaging, LLC Past Accepting new patients
Medical Imaging, PA Diagnostic Radiology Past Accepting new patients
Diagnostic Imaging Services, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: socrates.jamoulis@direct.tmcmed.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285632000000",
    "number": "1912980194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 414975",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641414975",
            "telephone_number": "816-455-0661",
            "fax_number": "816-454-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 N OAK TRFY",
            "address_2": "#100",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641552256",
            "telephone_number": "816-455-0661",
            "fax_number": "816-454-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMOULIS",
        "first_name": "SOCRATES",
        "middle_name": "C.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2010-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "143388",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "23369",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204795108",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2267634",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100124320C",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "26323071",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.