Individual provider Active NPI

Nikolaos Koutsonikolis, M.D.

  • Anesthesiology Physician
  • Iowa City, IA
National Provider Identifier
1982676961
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME80240 Issued in FL
Practice address
200 Hawkins Dr
Dept of Anesthesiology
Iowa City, IA 52242-1009
Phone
(563) 580-4107
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME80240 FL Primary
Anesthesiology Physician 207L00000X 31824 IA

Addresses

Primary practice location

200 Hawkins Dr
Dept of Anesthesiology
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Dept of Anesthesiology
Iowa City, IA 52242-1009
Phone (563) 580-4107

Other identifiers 2

IdentifierTypeStateIssuer
0152900MedicaidIA
32401900MedicaidWI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160519001014 FL Practitioner - Anesthesiology 8628038692 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Healthcorp IncGroup PAC ID 3173429693, 956 clinicians

Practice addresses (Care Compare)

1500 SE 1St Ave
Ocala, FL 34471-6504
Phone (352) 351-7200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME80240FLMDAnesthesiology Physician
31824IAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf-to-Bay Anesthesiology Associates LLC Anesthesiology CurrentSince Feb 1, 2017 Accepting new patients
Sheridan Healthcorp Inc Anesthesiology Current Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Anesthesiology CurrentSince Feb 1, 2017 Accepting new patients
Sheridan Healthcorp, Inc. Anesthesiology CurrentSince Nov 14, 2017 Accepting new patients
Sheridan Healthcorp Inc Anesthesiology CurrentSince Nov 14, 2017 Accepting new patients
Capital Anesthesia Solutions of Florida II, LLC Anesthesiology CurrentSince Oct 1, 2022 Accepting new patients

Locations

2020 59th St W
Bradenton, FL 34209
Phone (813) 798-6303

8300 Collier Blvd
Naples, FL 34114
Phone (239) 354-6000

1600 SE 17th St
Ocala, FL 34471
Phone (615) 240-3720

4600 SW 46th Ct
Ocala, FL 34474
Phone (352) 291-3000

1500 SW 1st Ave
Ocala, FL 34471
Phone (352) 351-7500

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

540 The Rialto
Venice, FL 34285
Phone (866) 481-2553

Networks

  • Freedom Health HMO Network

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 and National Provider Directory roles.

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1982676961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "address_2": "DEPT OF ANESTHESIOLOGY",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "563-580-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "address_2": "DEPT OF ANESTHESIOLOGY",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "563-580-4107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUTSONIKOLIS",
        "first_name": "NIKOLAOS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME80240",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "31824",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0152900",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32401900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.