Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lisa Marie Koumoulos, APN

Individual provider Adult Health Nurse Practitioner · NPI 1700482866

Lisa Marie Koumoulos, APN is a Nurse Practitioner in Hackensack, New Jersey. Qualified in 2020, 6 years ago. Practices with Excelcare Medical Associates PA, a 199-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New Jersey.

Years since qualifying
6
Licensed in
NJ
In the registry since
2020
What do these letters mean?
APN — Advanced Practice Nurse
The umbrella title some states use for nurse practitioners and other advanced practice nurses.

See every abbreviation used in this directory →

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Practice location Address checks out

92 Summit Ave
Hackensack, NJ 07601-1263
Phone: (201) 342-0066
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 26NJ01081600 (NJ)

Record details

NPI number1700482866
Entity typeIndividual (Type 1)
GenderFemale
Credentials APN
Sole proprietorNo
NPI enumeratedDecember 4, 2020
Last updated in NPPESJuly 27, 2026
Certification dateJuly 27, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Excelcare Medical Associates Pa — 199 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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