Individual provider Active NPI

George Hancock Kowallis, M.D.

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1962556340
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD115904-1 Issued in NY
Practice address
162 W 56TH St
Suite 407
New York, NY 10019-3831
Phone
(212) 757-0324
Fax
(212) 757-0324
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD115904-1 NY Primary
Child & Adolescent Psychiatry Physician 2084P0804X MD115904-1 NY

Addresses

Primary practice location

162 W 56TH St
Suite 407
New York, NY 10019-3831

Mailing address

162 W 56TH St
Suite 407
New York, NY 10019-3831
Phone (212) 757-0324

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090316000002 NY Practitioner - Psychiatry 6709943913 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Perelman School of Med at the University of Pennsylvania, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

162 W 56TH St
Suite 407
New York, NY 10019-3889
Phone (212) 757-0324

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD115904-1NYMDChild & Adolescent Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1962556340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 W 56TH ST",
            "address_2": "SUITE 407",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193831",
            "telephone_number": "212-757-0324",
            "fax_number": "212-757-0324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 W 56TH ST",
            "address_2": "SUITE 407",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193831",
            "telephone_number": "212-757-0324",
            "fax_number": "212-757-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALLIS",
        "first_name": "GEORGE",
        "middle_name": "HANCOCK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "MD115904-1",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "MD115904-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.