Kaitlyn Ann Coucoules

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C06063 Issued in MD

Practice address

23000 Moakley St
Suite 102
Leonardtown, MD 20650-2915

Phone

(301) 475-5555

Fax

(301) 475-5914

NPI assigned

Feb 23, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, FL2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

H Lee Moffitt Cancer Ctr and Res Inst Life Time Cancer SCRN Ctr IncGroup PAC ID 2264337021, 1,145 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• H Lee Moffitt Cancer Center & Research Institute I Hospital, Tampa, FL, CCN 100271

Merit-based Incentive Payment System (MIPS)

Final score

88 of 100Reported as group

Quality

74.04

Promoting interoperability

100

Improvement activities

40

Cost

70.96

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc

  • Hematology & Oncology Physician
  • Tampa, FL
  • NPI 1306833595

  FL

  Medicare reassignment Care Compare group
• Centers for Advanced Orthopaedics, LLC

  • Orthopaedic Surgery Physician
  • Olney, MD
  • NPI 1487093167

  MD

  Medicare reassignment
• Centers for Advanced Orthopaedics, LLC

  • Durable Medical Equipment & Medical Supplies
  • Hanover, MD
  • NPI 1760872709
  NPD
• Centers for Advanced Orthopaedics, LLC

  • Orthopaedic Surgery Physician
  • Gainesville, VA
  • NPI 1063393833
  NPD

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

• H. Lee Moffitt Cancer Center and Research Institute Hospital, Inc.

  • Special Hospital
  • Tampa, FL
  • NPI 1780653618

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481241600000",
    "number": "1992164669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23000 MOAKLEY ST",
            "address_2": "SUITE 102",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206502915",
            "telephone_number": "301-475-5555",
            "fax_number": "301-475-5914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23000 MOAKLEY ST",
            "address_2": "SUITE 102",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206502915",
            "telephone_number": "301-475-5555",
            "fax_number": "301-475-5914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUCOULES",
        "first_name": "KAITLYN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-23",
        "last_updated": "2016-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C06063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenelle L Cooper, MPT
• Cornerstone Montgomery, Inc.
• Cornerstone Montgomery, Inc.
• Cornerstone Montgomery, Inc.
• Cornerstone Montgomery, Inc.
• Asha Cox
• Lloyd G Cox II, MD
• Erica Jean Csuy, ATC
• Abigail Culbertson, CCC-SLP
• Cyreene

• All providers in Leonardtown, MD
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.