Individual provider Active NPI

Andrew Nicholas Kozlov, M.D.

  • Diagnostic Radiology Physician
  • Tampa, FL
National Provider Identifier
1093134702
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME150521 Issued in FL
Practice address
1 Tampa General Cir
Tampa, FL 33606-3571
Phone
(866) 844-1411
NPI assigned
Apr 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME150521 FL Primary

Addresses

Primary practice location

1 Tampa General Cir
Tampa, FL 33606-3571

Mailing address

2700 University Square Dr
Tampa, FL 33612-5513
Phone (813) 253-2721

Other practice location 1

355 Ridge Ave
Evanston, IL 60202
Phone (847) 316-3111

Other practice location 2

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address akozlov628944@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, UT2 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
I20210603000832 FL Practitioner - Diagnostic Radiology 9335474329 Reassigns benefits to 1 organization
I20230421001299 UT Practitioner - Nuclear MedicinePractitioner - Diagnostic Radiology 9335474329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nuclear MedicineAlso: Diagnostic Radiology
Education
University of Florida College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 213-2995

Hospital & facility affiliations

  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME150521FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Imaging LLC Diagnostic Radiology CurrentSince Jun 1, 2021 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Mar 15, 2023 Accepting new patients
Tower Imaging LLC Diagnostic Radiology CurrentSince Jun 1, 2021 Accepting new patients
Tower Imaging LLC Diagnostic Radiology Current Accepting new patients
University of Utah Adult Services Diagnostic Radiology CurrentSince Mar 15, 2023 Accepting new patients
Columbia Lutheran Charities Past Accepting new patients
Columbia Lutheran Charities Past Accepting new patients

Locations

2700 University Square Dr
Tampa, FL 33612
Phone (813) 251-5822

2106 S Lois Ave
Tampa, FL 33629
Phone (813) 287-1191

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 8

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 3

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": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1093134702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 UNIVERSITY SQUARE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336125513",
            "telephone_number": "813-253-2721",
            "fax_number": "813-594-5907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TAMPA GENERAL CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063571",
            "telephone_number": "866-844-1411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "355 Ridge Ave",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "60202",
            "country_code": "US",
            "telephone_number": "847-316-3111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Pasteur Dr",
            "address_purpose": "LOCATION",
            "city": "Stanford",
            "state": "CA",
            "postal_code": "943052200",
            "country_code": "US",
            "telephone_number": "650-723-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZLOV",
        "first_name": "ANDREW",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME150521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akozlov628944@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.