Revathi Kotla, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MA64664 Issued in NJ

Practice address

61 Joanna Way
Short Hills, NJ 07078-3206

Phone

(973) 758-1650

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Merit-based Incentive Payment System (MIPS)

Final score

94.27 of 100Reported as group

Quality

80.29

Promoting interoperability

100

Improvement activities

40

Cost

75.48

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: rkotla733022@achce.catholichealth.net
• Direct secure messaging: rkotla1279553@direct.ochsner.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.

• Revathi Kotla MD PC

  • Nephrology Physician
  • West Orange, NJ
  • NPI 1609343672
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1063506434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 JOANNA WAY",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070783206",
            "telephone_number": "973-758-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 JOANNA WAY",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070783206",
            "telephone_number": "973-758-1650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16777 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708163254",
            "country_code": "US",
            "telephone_number": "225-754-3289",
            "fax_number": "225-754-3277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTLA",
        "first_name": "REVATHI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "325921",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "MA64664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7697805",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kinder Healthcare Services
• Nancy Jo Kislin, LCSW
• Carissa A. Kitchell, RPH
• Valerie Jill Koren, RD
• Stephanie Kostolansky
• Theodore Ian Kramer, M.D.
• Jeanette Elrita Laroche, LCSW-R, LISW-CP
• Monica Laspada
• Raana Latif, PA-C
• Tri M Le, PHARM.D.

• Nephrology Physician in Short Hills, NJ
• Providers in Short Hills, NJ by specialty
• Nephrology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.