Medicare billing address
CMS Medicare provider billing file
35 Monument RdYork, PA 17403
CMS public data · NPI 1376676775
Dr. Theresa Kouo: Medicare billing data
CMS public files list billing, prescribing, location, and participation fields for this NPI. Current plan networks, appointment availability, clinical outcomes, and patient-specific medical advice require separate verification.
CMS display name
Theresa Kouo, MD
Specialty
Credential
MD
NPI
1376676775
Primary source state
PA
Data retrieval date
July 28, 2026
What related Medicare data is on this site?
Pennsylvania doctorsState Doctor hubDiagnostic RadiologyState-specialty hubYork, PAPrimary city link if this route exists
Where these numbers come from, and what they cannot tell you
Public CMS records, 2024 reporting year. These are historical Medicare fields, not proof of current coverage, appointment availability, quality, or what someone will pay.
How should you read this Doctor page?
This page shows Medicare billing and Part D prescribing data for Theresa Kouo, MD from CMS public files. It covers 2024 claims data: services billed, the beneficiary panel, and the most-prescribed Part D drugs. It does not show current coverage, appointment availability, or quality ratings.
A licensed agent, not a call center
Do your doctors and prescriptions fit before you enroll?
Peter Abilla, Licensed Medicare Insurance Sales Agent, NPN 22265186. Bring the doctors and prescriptions that matter to you, then check the details before you enroll.
What Medicare source indicators are listed for this NPI?
Medicare participating
Yes
Individual assignment
Yes
Group assignment
Yes
CMS opt-out records
0
Which practice locations appear in CMS files?
When CMS files list more than one address for the same NPI, each address stays tied to the CMS file that reported it.
York, PA 17403
WELLSPAN MEDICAL GROUP
CMS Doctors & Clinicians file
35 Monument RdSuite 201
York, PA 17403
What does the Medicare billing file show?
In the 2024 CMS provider billing file, this NPI had 3,016 Medicare beneficiaries and 4,551 total services. The average beneficiary age was 75, and the average HCC risk score was 1.8.
Total Medicare allowed amount
$183,375.01
Total Medicare payment amount
$136,827.35
Medicare beneficiaries
3,016
Total services
4,551
Which patient-panel condition fields does CMS report?
These percentages describe the Medicare beneficiary panel in the CMS utilization file. They are not a diagnosis for any individual patient and are not a quality score.
Hyperlipidemia
75%
CMS beneficiary-panel share
Hypertension
75%
CMS beneficiary-panel share
Ischemic heart disease
40%
CMS beneficiary-panel share
Mood disorders
38%
CMS beneficiary-panel share
Anxiety
37%
CMS beneficiary-panel share
Chronic kidney disease
36%
CMS beneficiary-panel share
Where these service numbers come from, and what they cannot tell you
Amounts shown are average Medicare-approved amounts per billed unit in CMS records. What a person pays depends on current coverage and cannot be read from this table alone.
Which Medicare services appear most often?
| CMS service description | Services | Avg allowed |
|---|---|---|
| X-ray of chest, 1 view | 642 | $7.98 |
| Ct scan head or brain without contrast | 345 | $36.85 |
| X-ray of chest, 2 views | 164 | $9.87 |
| X-ray of chest, 2 views | 155 | $9.92 |
| Ct scan of upper spine without contrast | 133 | $43.67 |
| Mri scan of brain before and after contrast | 128 | $101.35 |
| Ct scan of blood vessels of head with contrast | 122 | $77.08 |
| Ct scan of blood vessels of neck with contrast | 121 | $73.44 |
| Mri scan of brain without contrast | 115 | $65.46 |
| X-ray of shoulder, minimum of 2 views | 107 | $8.62 |
What background fields does CMS report?
Graduation year
2003
Group/practice field
Wellspan Medical Group
Telehealth reported
Not reported
What can this data not tell us?
- CMS billing data does not say whether this doctor appears in any Medicare Advantage plan directory.
- Where CMS withholds a count for privacy, we show that note instead of a number. A withheld count is not zero.
- CMS billing data does not list Medicare Advantage plan-directory status for this doctor.
- CMS service and prescribing records are historical public-use aggregates; they do not report current appointment availability, clinical outcomes, or patient-specific medical advice.
- Part D provider-and-drug records do not include current formulary status, copay amount, pharmacy price, prior-authorization rules, or step-therapy rules.
What should you verify separately?
Verify plan-directory status, drug formulary rules, pharmacy pricing, appointment availability, and clinical questions against current plan documents and the relevant provider or care team.
Which CMS sources support this page?
The numbers above come from CMS public-use files for this NPI. Each link identifies the CMS release used and the retrieval date.
- Medicare Physician & Other Practitioners - by Provider · 1 records for this NPI · retrieved July 28, 2026
- Medicare Physician & Other Practitioners - by Provider and Service · 71 records for this NPI · retrieved July 28, 2026
- Doctors and Clinicians National Downloadable File · 1 records for this NPI · retrieved July 28, 2026
- Opt-Out Affidavits · 0 records for this NPI · retrieved July 28, 2026
- Medicare Part D Prescribers - by Provider and Drug · 0 records for this NPI · retrieved July 28, 2026
What caveats apply to this page?
- CMS billing and utilization files do not list Medicare Advantage plan networks, appointment availability, or clinical outcomes.
- Part D provider-and-drug files are historical aggregate claims data; they do not report current medication lists, plan coverage, pharmacy price, or prior-authorization rules.
- Where CMS withholds a count for privacy, we show that note instead of a number. A withheld count is not zero.