Abdulrahman Al Kotob, M.D.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

Gengras Clinic at St. Frances Hospital
1000 Asylum Avenue, Suite 1004
Hartford, CT 06105

Phone

(860) 714-4632

Fax

(860) 714-8275

NPI assigned

Jun 21, 2022

Reactivated

May 18, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: aalkotob2388956@direct.trinity-health.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Waterville, ME
  • NPI 1134779531
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1003547035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GENGRAS CLINIC AT ST. FRANCES HOSPITAL",
            "address_2": "1000 ASYLUM AVENUE, SUITE 1004",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06105",
            "telephone_number": "860-714-4632",
            "fax_number": "860-714-8275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GENGRAS CLINIC AT ST. FRANCES HOSPITAL",
            "address_2": "1000 ASYLUM AVENUE, SUITE 1004",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06105",
            "telephone_number": "860-714-4632",
            "fax_number": "860-714-8275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL KOTOB",
        "first_name": "ABDULRAHMAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-21",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "deactivation_date": "2023-03-08",
        "reactivation_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Snehal Pralhad Akre, M.D.
• Sumona Akter Eity, DMD
• Amarachi Akwarandu
• Mina Al Ani
• Soltan Al Chaar, MD
• Ahmad Mohd Awad Al Nawaiseh, MD
• Areej Al Siaghy, MD
• Yasser A Al-Baghdadi, M.D.
• Yahya Al-Mezrakchi, MD
• Neveen Al-Said, DO

• Student in an Organized Health Care Education/Training Program in Hartford, CT
• Providers in Hartford, CT by specialty
• Student in an Organized Health Care Education/Training Program in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.