Stephen Kolakowski Jr., MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

C146610 Issued in CA

Practice address

13010 Hesperia Rd Ste 400
Victorville, CA 92395-8315

Phone

(760) 242-9355

NPI assigned

Dec 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Vascular Surgery

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Choice Healthcare Associates, Inc. 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Desert Valley Hospital Hospital, Victorville, CA, CCN 050709
• Victor Valley Global Medical Center Hospital, Victorville, CA, CCN 050517
• Providence St Mary Medical Center Hospital, Apple Valley, CA, CCN 050300

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ADAADD/Endpoint/ADAADD
• Direct secure messaging: stephenkolakowski@chai.allscriptsdirect.net
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: stephen.kolakowski.p1@direct.dvmg.nextgenshare.com

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.

• Choice Healthcare Associates, Inc.

  • Exclusive Provider Organization
  • Apple Valley, CA
  • NPI 1194964361

  CA

  Medicare reassignment Care Compare group NPD
• County of San Joaquin

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1801830583

  CA

  Medicare reassignment NPD
• Desert Valley Medical Group, Inc.

  • Physical Therapist
  • Victorville, CA
  • NPI 1639117864

  CA

  Medicare reassignment NPD
• Desert Vascular Center a Professional Medical Corporation

  • Diagnostic Radiology Physician
  • Apple Valley, CA
  • NPI 1073224085

  CA

  Medicare reassignment NPD
• San Joaquin Faculty Medical Group

  • Internal Medicine Physician
  • French Camp, CA
  • NPI 1225063761

  CA

  Medicare reassignment NPD
• USA Vascular Centers of Los Angeles, PC

  • Vascular Surgery Physician
  • Valley Village, CA
  • NPI 1679951362

  CA, Vascular Surgery

  Medicare reassignment NPD
• County of San Joaquin

  • Multi-Specialty Clinic/Center
  • Manteca, CA
  • NPI 1417407636
  NPD
• Desert Valley Medical Group, Inc

  • Family Medicine Physician
  • Chino, CA
  • NPI 1588246425
  NPD
• Desert Valley Medical Group, Inc

  • Internal Medicine Physician
  • Victorville, CA
  • NPI 1952020315
  NPD
• Choice Healthcare Associates Inc

  • Exclusive Provider Organization
  • Barstow, CA
  • NPI 1811038839
  NPD (past)
• County of San Joaquin

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1275605180
  NPD (past)
• Desert Valley Hospital, LLC

  • General Acute Care Hospital
  • Victorville, CA
  • NPI 1851396576
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Desert Valley Hospital, LLC

  • General Acute Care Hospital
  • Victorville, CA
  • NPI 1851396576

  Hospital

  Care Compare affiliation
• St. Mary Medical Center

  • Advanced Practice Midwife
  • Apple Valley, CA
  • NPI 1043406440

  Hospital

  Care Compare affiliation
• St. Mary Medical Center

  • General Acute Care Hospital
  • Apple Valley, CA
  • NPI 1669456299

  Hospital

  Care Compare affiliation
• St. Mary Medical Center

  • General Acute Care Hospital
  • Apple Valley, CA
  • NPI 1710109186

  Hospital

  Care Compare affiliation
• Victor Valley Hospital Acquisition, Inc.

  • General Acute Care Hospital
  • Victorville, CA
  • NPI 1679879589

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1003971102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19111 TOWN CENTER DR",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923088989",
            "telephone_number": "760-242-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13010 HESPERIA RD STE 400",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958315",
            "telephone_number": "760-242-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLAKOWSKI",
        "first_name": "STEPHEN",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "C146610",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA08206100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Knolls West Assisted Living, LLC.
• Knolls West Enterprises
• Knolls West Post Acute LLC
• Linna C Ko, PHARM D
• Samuel H Ko, D.D.S.
• Kong D Wong MD Inc
• Jennifer Konior, PA-C
• Alan Jay Koo
• Sandra Kopp, RN
• Edward Leonard Korthuis, D.C.

• All providers in Victorville, CA
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.