1. Home
  2. Directory
  3. Texas
  4. Tyler
  5. Internal Medicine
  6. NPI Profile

ANNA POULOS
NPI 1689121121
Internal Medicine in Tyler, TX

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: November 01, 2026.

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

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
Open in Google Maps ↗

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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Anna Poulos reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Oak Street Health Of Texas, PLLC
118 mi
Primary Care
4115 E LANCASTER AVE
Fort Worth, TX 76103
  • Reassigned Medicare billing, Texas enrollment
  • 175 clinicians in this Medicare group
NPI 1497387419 (312) 733-9730
Osh Mi Physicians Group, PC
364 mi
Primary Care
3360 N WATKINS ST
Memphis, TN 38127
  • Reassigned Medicare billing, Tennessee enrollment
  • 41 clinicians in this Medicare group
NPI 1720635790 (901) 401-7150

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 10

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

LAURA MOORE FNP-C
Nurse Practitioner (Family)
2115 S BROADWAY AVE
TYLER, TX 75701
Smith County (903) 907-7002
MRS. CLAUDIA CARVALHO WILSON FNP
Nurse Practitioner (Family)
2115 S BROADWAY AVE
TYLER, TX 75701
Smith County (903) 907-7002
BILLIE K HUFF FNP
Nurse Practitioner (Family)
2115 S BROADWAY AVE
TYLER, TX 75701
Smith County (903) 408-6592
MRS. COURTNEY COONER LCSW
Social Worker (Clinical)
2115 S BROADWAY AVE
TYLER, TX 75701
Smith County (903) 907-7002
CHRISTOS SARANTOPOULOS MD
Internal Medicine
2115 S BROADWAY AVE
TYLER, TX 75701
Smith County (773) 352-1515
MS. LAKIMBERELY SHAJUAN WOOTEN APRN
Nurse Practitioner (Family)
2115 S BROADWAY AVE
TYLER, TX 75701
Smith County (903) 907-7002
MS. GALINDA O'CONNOR F.N.P.
Nurse Practitioner (Family)
2115 S BROADWAY AVE
TYLER, TX 75701
Smith County (903) 907-7002
MARIELA OLMEDO FNP-C
Nurse Practitioner (Family)
2115 S BROADWAY AVE
TYLER, TX 75701
Smith County (903) 907-7002

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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.

Where is Anna Poulos located?

Anna Poulos practices at 2115 S Broadway Ave, Tyler, TX 75701. The listed phone number is (903) 907-7002.

What is Anna Poulos's specialty?

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

Is Anna Poulos enrolled in Medicare?

Yes. Anna Poulos is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Anna Poulos's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Anna Poulos reassigns Medicare benefits to 2 organizations: Oak Street Health Of Texas, PLLC (Fort Worth, TX) and Osh Mi Physicians Group, PC (Memphis, TN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Anna Poulos's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

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.