Individual provider Active NPI

Mark Karakourtis, D.D.S.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • West Lake Hills, TX
National Provider Identifier
1932320967
Registry record updated Mar 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
L5003 Issued in TX
Practice address
5656 Bee Cave Rd
Suite C102
West Lake Hills, TX 78746-5280
Phone
(512) 327-9933
Fax
(512) 327-9944
NPI assigned
May 1, 2007
Last updated
Mar 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 15919 TX
Surgical Oncology Physician 2086X0206X L5003 TX
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X L5003 TX Primary

Addresses

Primary practice location

5656 Bee Cave Rd
Suite C102
West Lake Hills, TX 78746-5280

Mailing address

7517 Cameron Rd
Suite 107
Austin, TX 78752-2057
Phone (512) 371-1222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160714001128 TX Order and Referring Only - DentistPractitioner - Dentist 8022073758

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L5003TXMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Carus Dental PC PastSince Jan 26, 2022 Accepting new patients
Carus Dental PC PastSince Jan 26, 2022 Accepting new patients
Carus Dental PC PastSince Jan 26, 2022 Accepting new patients
Innovative Physicians PastSince Apr 1, 2014 Accepting new patients
Texas Oral Maxillofacial Surgery Associates, PLLC Past Accepting new patients
Carus Dental Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520553600000",
    "number": "1932320967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7517 CAMERON RD",
            "address_2": "SUITE 107",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787522057",
            "telephone_number": "512-371-1222",
            "fax_number": "512-371-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 BEE CAVE RD",
            "address_2": "SUITE C102",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787465280",
            "telephone_number": "512-327-9933",
            "fax_number": "512-327-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARAKOURTIS",
        "first_name": "MARK",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2018-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "15919",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "TX",
            "license": "L5003",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "L5003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lake Hills, TX

Sources for this page

Verify at the official NPI Registry.