ALEXANDER GOUGOUTAS MD NPI 1821154790

NPI Information

NPI: 1821154790
Provider Name: ALEXANDER GOUGOUTAS, MD
Classification: Surgery - 2086S0122X
Entity Type: Individual

Specialization: Plastic and Reconstructive Surgery

PECOS Registration: Yes

Address:
3400 SPRUCE ST
1 MALONEY BUILDING
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 662-7659
Get Directions

Alexander Gougoutas, MD is a plastic and reconstructive surgery surgery in Philadelphia, PA. The provider is a surgeon who specializes in plastic and reconstructive surgery. Alexander Gougoutas, MD NPI is 1821154790. 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:

3400 SPRUCE ST
1 MALONEY BUILDING
PHILADELPHIA, PA
ZIP 19104-206
Phone: (215) 662-7659

The NPI 1821154790 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 12/28/2006 and was last updated on 11/2/2017.

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	2086S0122X	Surgery	Plastic and Reconstructive Surgery	MD60276102	WASHINGTON	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	8909038	OTHER	WASHINGTON	MEDICARE PIN
2	1821154790	MEDICAID	WASHINGTON

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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