DR. THOMAS N KOUTELOS INTERNAL MEDICINE NPI 1679647465

NPI Information

NPI: 1679647465
Provider Name: DR. THOMAS N KOUTELOS, INTERNAL MEDICINE
Classification: Specialist - 174400000X
Entity Type: Individual
Organization: NORTHERN MEDICAL GROUP, PLLC

PECOS Registration: Yes

Address:
25 PLAZA ST W STE 1F
421 78TH STREET BROOKLYN NY 11209
BROOKLYN, NY
ZIP 11217
Phone: (718) 622-1025
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DR. Thomas N Koutelos, INTERNAL MEDICINE is a specialist in Brooklyn, NY with 36 years of experience. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Thomas N Koutelos, INTERNAL MEDICINE NPI is 1679647465. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

25 PLAZA ST W STE 1F
421 78TH STREET BROOKLYN NY 11209
BROOKLYN, NY
ZIP 11217-942
Phone: (718) 622-1025
Fax: (718) 622-0915

The NPI 1679647465 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/20/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		19052 1	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	6638812006	OTHER	NEW YORK	CIGNA PPO HMO
2	190521	OTHER	NEW YORK	HIP OF NY
3	IC7375	OTHER	NEW YORK	ACS HEALTHNET OF NE
4	5699985	OTHER	NEW YORK	GHI
5	01366774	MEDICAID	NEW YORK
6	P809058	OTHER	NEW YORK	OXFORD
7	F42525	MEDICARE UPIN	NEW YORK
8	10L46	OTHER	NEW YORK	EMPIRE BC-BS
9	10L461	MEDICARE ID-TYPE UNSPECIFIED
10	2023469	OTHER	NEW YORK	AETNA HMO PPO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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