Individual provider Active NPI

Kayla Kotake, DPT

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1154008217
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5153 Issued in NV
Practice address
888 W Bonneville Ave
Las Vegas, NV 89106-0100
Phone
(702) 483-6000
NPI assigned
Jun 30, 2023
Last updated
Jun 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5153 NV Primary

Addresses

Primary practice location

888 W Bonneville Ave
Las Vegas, NV 89106-0100

Mailing address

888 W Bonneville Ave
Las Vegas, NV 89106-0100
Phone (702) 483-6000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240404001952 NV Practitioner - Physical Therapist in Private Practice 9931547353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland Clinic NevadaGroup PAC ID 9537219431, 31 clinicians

Practice addresses (Care Compare)

888 W Bonneville Ave
Las Vegas, NV 89106-0100
Phone (702) 483-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5153NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Clinic Nevada Physical Therapist CurrentSince Feb 10, 2024 Accepting new patients

Locations

888 W Bonneville Ave
Las Vegas, NV 89106
Phone (702) 263-9797

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1154008217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 W BONNEVILLE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891060100",
            "telephone_number": "702-483-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 W BONNEVILLE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891060100",
            "telephone_number": "702-483-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTAKE",
        "first_name": "KAYLA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "5153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.