Individual provider Active NPI

Ilan D. Kolkowitz, MD

  • Emergency Medicine Physician
  • Madison, WI
National Provider Identifier
1245760818
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
71357-20 Issued in WI
Practice address
214 S Randall Ave
Madison, WI 53715-1544
Phone
(650) 906-8289
NPI assigned
Jun 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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 71357-20 WI Primary
Surgery Physician 208600000X 125.070938 IL

Addresses

Primary practice location

214 S Randall Ave
Madison, WI 53715-1544

Mailing address

214 S Randall Ave
Madison, WI 53715-1544

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ikolkowitz857001@direct.uwhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 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
I20230731002103 WA Practitioner - Emergency Medicine 1153690557 Reassigns benefits to 2 organizations
I20231020002783 OR Practitioner - Emergency Medicine 1153690557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, San Diego School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Associates PCGroup PAC ID 3870526858, 37 clinicians

Practice addresses (Care Compare)

600 NE 92ND Ave
Vancouver, WA 98664-3225
Phone (360) 514-2142

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.76
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.070938ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Oct 9, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Emergency Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Oct 9, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Emergency Medicine CurrentSince Oct 9, 2023 Accepting new patients
Emergency Medicine Associates PC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Peacehealth PastSince Aug 1, 2023 Accepting new patients

Locations

10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

600 NE 92nd Ave
Vancouver, WA 98664
Phone (360) 514-2142

Interoperability endpoints

  • Direct secure messaging: ikolkowitz619735@direct.peacehealth.org
  • Direct secure messaging: ikolkowitz857001@direct.uwhealth.org

Organizations & group practices 6

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.

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": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1245760818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 S RANDALL AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 S RANDALL AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151544",
            "telephone_number": "650-906-8289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLKOWITZ",
        "first_name": "ILAN",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-15",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "71357-20",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125.070938",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ikolkowitz857001@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "600 Highland Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537920001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.