PHILIP D. KOUSOUBRIS (NPI# 1447350442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447350442 |
| Entity Type | Individual |
| Full Name | PHILIP D. KOUSOUBRIS |
| Credential | M.D. |
| Practice Address |
Lahey Clinic 41 Mall Road Burlington MA 01805-0001 |
| Practice Telephone | 7817448170 |
| Practice Fax Number | 7817445232 |
| Mailing Telephone | 7817448170 |
| Mailing Fax Number | 7817445232 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2010-11-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
160515 | MA | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
160515 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110061235A | 05 | |
| MA | 3194523 | 05 |
| Street Address |
LAHEY CLINIC 41 MALL ROAD |
| City | BURLINGTON |
| State | MA |
| Zip Code | 01805-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568455350 | Julie L Jones | Nurse Practitioner | Lahey Clinic, 41 Mall Road, Burlington, MA 01805-0001 | 2005-08-26 |
| 1801168042 | Michelle E. Howlett | Physician Assistant | Lahey Clinic, 41 Mall Road, Burlington, MA 01805-0001 | 2012-02-03 |
| 1760767842 | Emily K. Newcomb | Physician Assistant | Lahey Clinic, 41 Mall Road, Burlington, MA 01805-0001 | 2011-10-20 |
| 1053693549 | Christine Ackroyd | Nurse Practitioner | Lahey Clinic, 41 Mall Rd., Burlington, MA 01805-0001 | 2011-09-12 |
| 1609160514 | Diana H Cabral | Nurse Practitioner | Lahey Clinic, 41 Mall Rd., Burlington, MA 01805-0001 | 2011-06-08 |
| 1942504279 | Ashley Rae Drapeau | Physician Assistant | Lahey Clinic, 41 Mall Road, Burlington, MA 01805-0001 | 2010-12-30 |
| 1710289566 | Pamela S. Sherry | Pharmacist | Lahey Clinic, 41 Mall Road, Burlington, MA 01805-0001 | 2010-11-30 |
| 1932418555 | Bettina Norma Johnson | Nurse Practitioner | Lahey Clinic, 41 Mall Road, Burlington, MA 01805-0001 | 2010-09-30 |
| 1164671509 | Kara Del Torchio | Nurse Practitioner | Lahey Clinic, 41 Mall Rd, Burlington, MA 01805-0001 | 2008-09-10 |
| 1013163534 | David A Rosman | Radiology | Lahey Clinic, 41 Mall Road, Burlington, MA 01805-0001 | 2008-08-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750867909 | Natalie Teresa Dal'bo | Student in an Organized Health Care Education/Training Program | 41 Mall Road Office of Graduate Medical Education, Burlington, MA 01805 | 2018-07-11 |
| 1043710791 | Beth Israel Lahey Health Primary Care, Inc. | Urology | Lahey Institute of Urology, Beverly, 41 Mall Rd., Burlington, MA 01805 | 2018-02-20 |
| 1902240872 | Lloyd Jones Jr. | Student in an Organized Health Care Education/Training Program | 41 Mall Rd Department of Plastic Surgery, Burlington, MA 01805 | 2013-04-23 |
| 1508020470 | Russell Andrew Baur | Internal Medicine | Lahey Clinic Inc., 41 Mall Road, Burlington, MA 01805 | 2008-07-10 |
| 1356491237 | Jacob Magee Sands | Internal Medicine | 41 Burlington Mall Rd., Lahey Clinic, Burlington, MA 01805 | 2007-01-11 |
| 1588757108 | Richard Alan Wold | Nurse Anesthetist, Certified Registered | Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA 01805 | 2006-10-02 |
| 1841302387 | David M. Venesy | Internal Medicine | Lahey Clinic Cardiology -5 E, 41 Mall Road, Burlington, MA 01805 | 2006-08-31 |
| 1790750354 | Cara J. Foss | Nurse Practitioner | Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA 01805 | 2006-02-17 |
| 1750376380 | Darryl D Esakof | Internal Medicine | 41 Mall Road, Department of Cardiovascular Medicine, Lahey Clinic, Burlington, MA 01805 | 2005-09-20 |
| 1225022155 | Laura Saluja | Internal Medicine | Lahey Clinic - General Internal Medicine, 41 Mall Road, Burlington, MA 01805 | 2005-09-07 |
| Find all providers in zip 01805 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457643272 | Matthew G. Geeslin | Radiology | 111 Colchester Ave Dept Of, Burlington, VT 05401-1473 | 2011-05-12 |
| 1871825281 | Gregory Day | Radiology | 2609 Bittersweet Pl, Burlington, IA 52601-2510 | 2010-02-10 |
| 1619045960 | James Howard Small | Radiology | 1017 N 4th St, Burlington, IA 52601-4804 | 2006-12-02 |
| 1790892834 | Tai M Tran | Radiology | Lahey Medical Ctr, 41 Mall Road, Burlington, MA 01805-0001 | 2006-08-24 |
| 1205846151 | Peter Hongkyun Lee | Radiology | 41 Mall Rd Lahey Hospital and Medical Ctr, Burlington, MA 01805-2961 | 2006-08-09 |
| 1467499053 | Jane C Primm | Radiology | 111 Colchester Ave, Acc-2nd Fl, Fletcher Allen Health Care, Burlington, VT 05401-1473 | 2006-06-01 |
| 1336106533 | Lisl Warren | Radiology | Lahey Clinic/radiology, 41 Mall Road, Burlington, MA 01805-0001 | 2006-05-01 |
| 1326046970 | Urvi Fulwadhva | Radiology | Lahey Clinic, Inc., 41 Mall Road, Burlington, MA 01805-0001 | 2005-07-08 |
| 1922594019 | Paschalis Toskas | Radiology | 41 Burlington Mall Road, Burlington, MA 01805 | 2018-07-02 |
| 1043763758 | Richard Thomas | Radiology | Lahey Hospital & Medical Center, 41 Mall Road, Burlington, MA 01805 | 2016-07-28 |
| Find all providers in BURLINGTON | ||||
| City | BURLINGTON |
| Zip Code | 01805 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.