Nathaniel Theodore Koutlas, MD is a medicare enrolled "Orthopaedic Surgery - Adult Reconstructive Orthopaedic Surgery" physician in Alcoa, Tennessee. His current practice location is
1146 Franck St, 101, Alcoa, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(865) 694-7725.
Nathaniel Theodore Koutlas is licensed to practice in Tennessee (license number 74215) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1609439694.
Physician's Profile
| Full Name | Nathaniel Theodore Koutlas |
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| Gender | Male |
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| Speciality | Orthopaedic Surgery - Adult Reconstructive Orthopaedic Surgery |
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| Location | 1146 Franck St, Alcoa, Tennessee |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1609439694
- Provider Enumeration Date: 04/16/2019
- Last Update Date: 08/07/2025
Medicare PECOS Information:
- PECOS PAC ID: 2466795463
- Enrollment ID: I20240701001465
Medical Identifiers
Medical identifiers for Nathaniel Theodore Koutlas such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1609439694 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207XS0114X | Orthopaedic Surgery - Adult Reconstructive Orthopaedic Surgery | 74215 (Tennessee) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Nathaniel Theodore Koutlas allows following entities to bill medicare on his behalf.
| Entity Name | Endeavor Health Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1497701882 PECOS PAC ID: 2163334699 Enrollment ID: O20040524000118 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nathaniel Theodore Koutlas is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Nathaniel Theodore Koutlas, MD Po Box 306556, Nashville, TN 37230-6556 Ph: (615) 329-2294 | Nathaniel Theodore Koutlas, MD 1146 Franck St, 101, Alcoa, TN 37701 Ph: (865) 694-7725 |
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