Nicole Koulisis, MD in Encino, CA - Medicare Ophthalmology

Nicole Koulisis, MD is a medicare enrolled "Ophthalmology - Retina Specialist" physician in Encino, California. She graduated from medical school in 2017 and has 7 years of diverse experience with area of expertise as Ophthalmology. She is a member of the group practice Retina Los Angeles and her current practice location is 5400 Balboa Blvd Ste 126, Encino, California. You can reach out to her office (for appointments etc.) via phone at (818) 578-0004.

Nicole Koulisis is licensed to practice in California (license number A157849) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1073033213.

Contact Information

	Nicole Koulisis, MD
	5400 Balboa Blvd Ste 126, Encino, CA 91316-5202
	(818) 578-0004
	(818) 578-0002

Map and Direction

Physician's Profile

Full Name	Nicole Koulisis
Gender	Female
Speciality	Ophthalmology
Experience	7 Years
Location	5400 Balboa Blvd Ste 126, Encino, California
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Nicole Koulisis graduated from medical school in 2017

NPI Data:

NPI Number: 1073033213
Provider Enumeration Date: 06/20/2017
Last Update Date: 12/01/2022

Medicare PECOS Information:

PECOS PAC ID: 8921379439
Enrollment ID: I20210610001639

Medical Identifiers

Medical identifiers for Nicole Koulisis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1073033213	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207W00000X	Ophthalmology	A157849 (California)	Secondary
207WX0107X	Ophthalmology - Retina Specialist	A157849 (California)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Retina Los Angeles	7315319191	2

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. Nicole Koulisis allows following entities to bill medicare on her behalf.

Entity Name	Retina Vitreous Associates Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1134164023 PECOS PAC ID: 5799769584 Enrollment ID: O20040617001206

Entity Name	Usc Care Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1902846306 PECOS PAC ID: 0446157747 Enrollment ID: O20050512000412

Entity Name	Retina Los Angeles
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1134845837 PECOS PAC ID: 7315319191 Enrollment ID: O20230203000416

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. Nicole Koulisis 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
Nicole Koulisis, MD 5400 Balboa Blvd Ste 126, Encino, CA 91316-5202 Ph: (818) 578-0004	Nicole Koulisis, MD 5400 Balboa Blvd Ste 126, Encino, CA 91316-5202 Ph: (818) 578-0004

Reviews and Comments

Ophthalmology Doctors in Encino, CA

Hajir Dadgostar, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 16500 Ventura Blvd, Suite 250, Encino, CA 91436 Phone: 818-788-9333 Fax: 818-788-9273
Dr. Mark H Kramar, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 16311 Ventura Blvd, Suite #750, Encino, CA 91436 Phone: 818-990-3623 Fax: 818-788-1056
John G Rezapour, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 16661 Ventura Blvd Ste 211, Encino, CA 91436 Phone: 818-205-1200 Fax: 818-205-1254
Dr. Stanley M Kopelow, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 16311 Ventura Blvd, Suite 750, Encino, CA 91436 Phone: 818-990-3623 Fax: 818-788-1056
Dr. Mohammad Reza Kalantari Nejad, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 16661 Ventura Blvd, Suite 312, Encino, CA 91436 Phone: 818-380-9191 Fax: 818-380-9190
Sheryl M Handler, M.D. Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 16311 Ventura Blvd, Suite 980, Encino, CA 91436 Phone: 818-789-2226 Fax: 818-789-2353

Nicole Koulisis, MD - Medicare Ophthalmology in Encino, CA