NPIMap

Individual provider Active NPI

Jayarathne Kottage, MD

  • Specialist
  • Fredericksburg, VA
National Provider Identifier
1043236284
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101254569 Issued in VA
Practice address
300 Park Hill Dr
Fredericksburg, VA 22401-3387
Phone
(540) 368-7405
Fax
(540) 368-7599
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 2004021469 MO
Specialist 174400000X 0101254569 VA Primary

Addresses

Primary practice location

300 Park Hill Dr
Fredericksburg, VA 22401-3387

Mailing address

1515 Idlewild Blvd
Fredericksbrg, VA 22401-6623
Phone (240) 778-3761

Other identifiers 1

IdentifierTypeStateIssuer
209339001MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140130000935 VA Practitioner - Physical Medicine and Rehabilitation 9830176924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1051 Care Way
Suite 200
Fredericksburg, VA 22401-8425
Phone (540) 371-7137

300 Park Hill Dr
Fredericksburg, VA 22401-3387
Phone (240) 778-3761

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Midlothian, VA, CCN 497538
  • Mary Washington Hospital Hospital, Fredericksburg, VA, CCN 490022
  • Encompass Health Rehab Hospital of Fredericksburg Inpatient rehabilitation facility, Fredericksburg, VA, CCN 493032

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101254569VAMDSpecialist
2004021469MOMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Management and Rehabilitation LLC CurrentSince Dec 17, 2013 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Rehabilitation Institute of Michigan Past Accepting new patients
Health Management and Rehabilitation LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1051 Care Way
Ste 200
Fredericksburg, VA 22401
Phone (540) 369-4461

300 Park Hill Dr
Fredericksburg, VA 22401
Phone (540) 361-7641

Organizations & group practices 5

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1043236284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 IDLEWILD BLVD",
            "city": "FREDERICKSBRG",
            "state": "VA",
            "postal_code": "224016623",
            "telephone_number": "240-778-3761",
            "fax_number": "540-368-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PARK HILL DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013387",
            "telephone_number": "540-368-7405",
            "fax_number": "540-368-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTTAGE",
        "first_name": "JAYARATHNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "2004021469",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101254569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209339001",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.