Individual provider Active NPI

Rudolf J Kotula, MD

  • Infectious Disease Physician
  • Omaha, NE
National Provider Identifier
1063477834
Registry record updated Jan 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
21269 Issued in NE
Practice address
10060 Regency Cir
Omaha, NE 68114-3732
Phone
(402) 354-1530
Fax
(402) 354-1535
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 43587 CO
Infectious Disease Physician 207RI0200X 21269 NE Primary

Addresses

Primary practice location

10060 Regency Cir
Omaha, NE 68114-3732

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Other identifiers 2

IdentifierTypeStateIssuer
1063477834MedicaidIA
47068731742MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090617000093 NE Practitioner - Infectious Disease 0941229173 Reassigns benefits to 1 organization
I20180718000627 IA Practitioner - Infectious Disease 0941229173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

10060 Regency Cir
Omaha, NE 68114-3732
Phone (402) 354-1570

933 E Pierce St
Methodist Jennie Edmundson
Council Bluffs, IA 51503-4626
Phone (712) 396-6000

Hospital & facility affiliations

  • The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040
  • Methodist Jennie Edmundson Hospital, Council Bluffs, IA, CCN 160047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21269NEMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Methodist Hospital Current Accepting new patients
Physicians Clinic Inc Infectious Disease CurrentSince Jun 30, 2009 Accepting new patients
Internal Medicine Associates of Lee County MD PA PastSince Aug 1, 2012 Accepting new patients
Colorado Infectious Disease Associates, LLP Infectious Disease Past Accepting new patients
Infectious Diseases Associates PC Infectious Disease PastSince Jun 30, 2024 Accepting new patients

Locations

1 Edmundson Pl
Ste 310
Council Bluffs, IA 51503
Phone (712) 328-1801

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

933 E Pierce St
Council Bluffs, IA 51503
Phone (712) 328-6000

16120 W Dodge Rd
Omaha, NE 68118
Phone (402) 354-0550

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

8901 W Dodge Rd
Omaha, NE 68114
Phone (402) 354-8600

5908 S 142nd St
Omaha, NE 68137
Phone (402) 354-1900

825 S 169th St
Fl 3
Omaha, NE 68118
Phone (402) 354-5451

8601 W Dodge Rd
Ste 216
Omaha, NE 68114
Phone (402) 354-4822

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15913/brand/10/csg/1/fhir/r4
  • Direct secure messaging: rudolf.kotula@direct.nmhs.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/49ec4064-7609-4f62-b5e6-20a05e00549b/

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 2

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388707200000",
    "number": "1063477834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10060 REGENCY CIR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143732",
            "telephone_number": "402-354-1530",
            "fax_number": "402-354-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTULA",
        "first_name": "RUDOLF",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2014-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "43587",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NE",
            "license": "21269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063477834",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731742",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.