Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Yiannis Koutsofavas, PA-C

Individual provider Physician Assistant · NPI 1164317194

Yiannis Koutsofavas, PA-C is a Physician Assistant in East Providence, Rhode Island. Graduated from Pennsylvania State University College of Medicine in 2025, 1 year ago. Licensed in Rhode Island.

Years since qualifying
1
Trained at
Pennsylvania State University College of Medicine
Licensed in
RI
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

684 Warren Ave
East Providence, RI 02914-1405
Phone: (401) 434-0022
Fax: (401) 434-6111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA01799 (RI)

Record details

NPI number1164317194
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 10, 2025
Last updated in NPPESApril 14, 2026
Certification dateApril 14, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolPENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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