Individual provider Active NPI

Paul Kotzampaltiris, DO

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Framingham, MA
National Provider Identifier
1083658686
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
208732 Issued in MA
Practice address
115 Lincoln Street
Metrowest Medical Center
Framingham, MA 01702
Phone
(508) 655-0636
Fax
(508) 655-0665
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 208732 MA
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 208732 MA Primary

Addresses

Primary practice location

115 Lincoln Street
Metrowest Medical Center
Framingham, MA 01702

Mailing address

PO Box 449
Natick, MA 01760-0005
Phone (508) 655-0636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20101109000495 MA Practitioner - Emergency Medicine 5799708038 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
208732MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Associates of Massachusetts PC Emergency Medicine CurrentSince May 25, 2023 Accepting new patients
Orthopaedic Surgery Specialist of Montclair, LLC Past Accepting new patients
Joseph Peter Fodero MD PA Past Accepting new patients

Locations

115 Lincoln St
Framingham, MA 01702
Phone (508) 383-1000

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1083658686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 449",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017600005",
            "telephone_number": "508-655-0636",
            "fax_number": "508-655-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 LINCOLN STREET",
            "address_2": "METROWEST MEDICAL CENTER",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "01702",
            "telephone_number": "508-655-0636",
            "fax_number": "508-655-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTZAMPALTIRIS",
        "first_name": "PAUL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "208732",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "MA",
            "license": "208732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Framingham, MA

Sources for this page

Verify at the official NPI Registry.