DEMETRIUS MARCOULIDES NP - NPI 1952887093 - Nurse Practitioner in Chicago, IL

Q: What is Demetrius Marcoulides's NPI number?

The NPI number for Demetrius Marcoulides is 1952887093. It was assigned to this individual provider in the NPPES registry on July 12, 2018.

Q: What is Demetrius Marcoulides's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

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About Demetrius Marcoulides Np NPPES

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

DEMETRIUS MARCOULIDES NP (NPI 1952887093) is an individual gerontology provider in Chicago, Illinois, licensed in Illinois (277.005052) and active in the NPI registry since July 2018. He is enrolled in Medicare PECOS, maintains a secondary practice location in Chicago, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1952887093

Entity TypeIndividualMale

Primary Taxonomy363LG0600X

Provider Legal NameDEMETRIUS MARCOULIDESCredential: NP

Location Address4417 W DIVERSEY AVEChicago, IL 60639-1923

Mailing AddressPo Box 746715Atlanta, GA 30374-6715 · (773) 352-1515 · Fax (312) 929-0373

Phone(815) 642-5723

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateJuly 12, 2018

Last NPPES UpdateJanuary 13, 20266 updates tracked since enumeration

NPPES CertifiedJanuary 13, 2026

✔ NPI 1952887093 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in IL · 277.005052

4417 W DIVERSEY AVE, Chicago, IL 60639

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Secondary Practice Location 1

Location 13010 W 26th StChicago, IL 60623-4128 · Phone (847) 220-4103

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

Demetrius Marcoulides Np 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 ID5991139065

PECOS Enrollment IDI20210419002153

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 60639 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

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

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 12

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

DEBORAH LYNNE EDBERG M.D.

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