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ADAM P KOUNS MD
NPI 1942509203
Internal Medicine - Pulmonary Disease in Cincinnati, OH

Active since March 24, 2011PECOS EnrolledAccepts Medicare Assignment
3301 MERCY HEALTH BLVD STE 300, CINCINNATI, OH 45211(513) 559-7025(513) 981-5755 Get Directions Write a Review

NPPES record last updated: August 15, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Adam P Kouns Md NPPES

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

ADAM P KOUNS MD (NPI 1942509203) is an individual pulmonary disease provider in Cincinnati, Ohio, licensed in Ohio (35.134401) and active in the NPI registry since March 2011. He is enrolled in Medicare PECOS, is affiliated with Mercy Health-anderson Hospital, and is a graduate of University Of Kentucky College Of Medicine (2011).

NPPES Registry Identity

NPI1942509203
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameADAM P KOUNSCredential: MD
Location Address3301 MERCY HEALTH BLVD STE 300Cincinnati, OH 45211
Mailing Address3301 Mercy Health Blvd Ste 300Cincinnati, OH 45211-1109 · (513) 559-7025 · Fax (513) 981-5755
Phone(513) 559-7025
Fax(513) 981-5755
Sole ProprietorNo
Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 2011
Enumeration DateMarch 24, 2011
Last NPPES UpdateAugust 15, 2018
✔ NPI 1942509203 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in OH · 35.134401
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal MedicineTaxonomy 207R00000X · License 125060346 (IL)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3301 MERCY HEALTH BLVD STE 300, Cincinnati, OH 45211
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

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

Adam P Kouns Md 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 ID5799088639
PECOS Enrollment IDI20180926002753
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 10

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.
134 services82 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
99 services61 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
95 services50 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
86 services45 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.
79 services67 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
72 services70 patients

Hospital Affiliations CMS Care Compare 3

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

Mercy Health-Anderson Hospital

Acute Care Hospitals · Cincinnati, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360001
Location7500 State RoadCincinnati, OH 45255 · Hamilton County
Emergency services Birthing friendly

Mercy Health - Fairfield Hospital

Acute Care Hospitals · Fairfield, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360056
Location3000 Mack RoadFairfield, OH 45014 · Butler County
Emergency services Birthing friendly

Mercy Health - West Hospital

Acute Care Hospitals · Cincinnati, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360234
Location3300 Mercy Health BlvdCincinnati, OH 45211 · Hamilton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45211 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
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
52%27 patients2/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
71%21 patients3/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
79%28 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 12

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
5 suppliers17 claims17 services$30.24 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
2 suppliers12 claims19 services$29.70 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
5 suppliers14 claims14 services$34.35 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
6 suppliers12 claims12 services$14.74 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
6 suppliers20 claims103 services$1.50 avg. paid by Medicare
Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046
DME-Other DME · category DE001N
5 suppliers11 claims11 services$10.31 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 4

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

BASHAR BRIJAWI MD
Psychiatry & Neurology (Sleep Medicine)
3301 MERCY HEALTH BLVD STE 300
CINCINNATI, OH 45211
Hamilton County (513) 559-7025
YOUSEF A AL AHWEL MD
Internal Medicine (Pulmonary Disease)
3301 MERCY HEALTH BLVD STE 300
CINCINNATI, OH 45211
Hamilton County (513) 559-7025
KYLE DARNELL MD
Internal Medicine (Pulmonary Disease)
3301 MERCY HEALTH BLVD STE 300
CINCINNATI, OH 45211
Hamilton County (513) 559-7025
MRS. PAIGE E OBERT AG-ACNP, BC
Nurse Practitioner (Gerontology)
3301 MERCY HEALTH BLVD STE 300
CINCINNATI, OH 45211
Hamilton County (513) 559-7025

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 Adam Kouns's NPI number?

The NPI number for Adam Kouns is 1942509203. It was assigned to this individual provider in the NPPES registry on March 24, 2011.

Where is Adam Kouns located?

Adam Kouns practices at 3301 Mercy Health Blvd Ste 300, Cincinnati, OH 45211. The listed phone number is (513) 559-7025.

What is Adam Kouns's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Adam Kouns enrolled in Medicare?

Yes. Adam Kouns is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Adam Kouns accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and MedMutual and 2 other insurers list Adam Kouns as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Adam Kouns affiliated with any hospitals?

According to CMS data, Adam Kouns is affiliated with Mercy Health-Anderson Hospital, Mercy Health - Fairfield Hospital and Mercy Health - West Hospital.

When was this NPI record last updated?

The NPPES record for Adam Kouns was last updated on August 15, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.