ANNA POULOS
NPI 1689121121
Internal Medicine in Tyler, TX

Q: What is Anna Poulos's NPI number?

The NPI number for Anna Poulos is 1689121121. It was assigned to this individual provider in the NPPES registry on September 1, 2016.

Q: What is Anna Poulos's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Anna Poulos was last updated on August 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 01, 2016PECOS Enrolled

2115 S BROADWAY AVE, TYLER, TX 75701(903) 907-7002 Get Directions Write a Review

NPPES record last updated: August 9, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 9, 2023, Mar 16, 2020, Feb 14, 2020 and 4 more (7 updates tracked since 2016).

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About Anna Poulos NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANNA POULOS (NPI 1689121121) is an individual internal medicine provider in Tyler, Texas, licensed in Texas (R8811) and active in the NPI registry since September 2016. She is enrolled in Medicare PECOS and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1689121121

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameANNA POULOS

Location Address2115 S BROADWAY AVETyler, TX 75701-4214

Mailing AddressPo Box 746079Atlanta, GA 30374-6079 · (312) 733-9730 · Fax (773) 866-8014

Phone(903) 907-7002

Sole ProprietorNo

Enumeration DateSeptember 1, 2016

Last NPPES UpdateAugust 9, 20237 updates tracked since enumeration

NPPES CertifiedAugust 9, 2023

✔ NPI 1689121121 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in TX · R8811✔ Licensed in TN · 57800✔ Licensed in NY · 175360

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

2115 S BROADWAY AVE, Tyler, TX 75701

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Secondary Practice Locations 4

Location 13360 N Watkins StMemphis, TN 38127-6432 · Phone (901) 401-7150 · Fax (901) 347-1285

Location 23889 Park AveMemphis, TN 38111-6634 · Phone (901) 401-7140

Location 32360 Gus Thomasson RdDallas, TX 75228-3005 · Phone (214) 301-7071

Location 44115 E Lancaster AveFort Worth, TX 76103-3614 · Phone (817) 796-7370 · Fax (817) 764-0714

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Anna Poulos is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75701 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$126.40 typical visit price

range $54.84 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers16 claims16 services$173.33 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASHLEY CHOU M.D.

Internal Medicine