Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

LISA MARIE KOUMOULOS APN
NPI 1700482866
Nurse Practitioner - Adult Health in Hackensack, NJ

Q: What is Lisa Marie Koumoulos's NPI number?

The NPI number for Lisa Marie Koumoulos is 1700482866. It was assigned to this individual provider in the NPPES registry on December 4, 2020.

Q: What is Lisa Marie Koumoulos's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Active since December 04, 2020PECOS Enrolled

92 SUMMIT AVE, HACKENSACK, NJ 07601(201) 342-0066 Get Directions Write a Review

NPPES record last updated: July 27, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 27, 2026, Dec 11, 2025, Dec 4, 2020 (3 updates tracked since 2020).

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About Lisa Marie Koumoulos Apn NPPES

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

LISA MARIE KOUMOULOS APN (NPI 1700482866) is an individual adult health provider in Hackensack, New Jersey, licensed in New Jersey (26NJ01081600) and active in the NPI registry since December 2020. She is enrolled in Medicare PECOS, is affiliated with Hackensack University Medical Center, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1700482866

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameLISA MARIE KOUMOULOSCredential: APN

Location Address92 SUMMIT AVEHackensack, NJ 07601-1263

Mailing Address331 Newman Springs Rd, Bldg 2, Ste 220Red Bank, NJ 07701-5688

Phone(201) 342-0066

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateDecember 4, 2020

Last NPPES UpdateJuly 27, 20263 updates tracked since enumeration

NPPES CertifiedJuly 27, 2026

✔ NPI 1700482866 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in NJ · 26NJ01081600

92 SUMMIT AVE, Hackensack, NJ 07601

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lisa Marie Koumoulos Apn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9335545573

PECOS Enrollment IDI20210914000017

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.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

74 services54 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

68 services50 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

22 services22 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

17 services16 patients

Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811

This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.

16 services16 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

16 services16 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Hackensack University Medical Center

Acute Care Hospitals · Hackensack, NJ

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310001

Location30 Prospect AveHackensack, NJ 07601 · Bergen County

Emergency services Birthing friendly

Holy Name Medical Center

Acute Care Hospitals · Teaneck, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310008

Location718 Teaneck RdTeaneck, NJ 07666 · Bergen County

Emergency services Birthing friendly

Valley Hospital

Acute Care Hospitals · Paramus, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310012

Location4 Valley Health PlazaParamus, NJ 07652 · Bergen County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07601 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

$98.09 typical visit price

range $63.84 – $190.92

Typical copayment $24.52 (range $15.96 – $47.73)

Most-billed visit code 99203

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

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.

Other Providers at the Same Location NPPES 20

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

ALEXANDRA SCHULSINGER

Nurse Practitioner (Adult Health)