Anisha Durga Kothari, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10003156A Issued in IN

Practice address

415 S Landmark Ave
Bloomington, IN 47403-5003

Phone

(812) 932-2387

Fax

(812) 222-0104

NPI assigned

Dec 29, 2020

Last updated

Jul 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Laser and Skin Surgery Center of Indiana PCGroup PAC ID 5193906899, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.54 of 100Reported as group

Quality

85

Promoting interoperability

100

Improvement activities

40

Cost

73.46

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: anisha@thelassi.emadirect.md

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.

• Laser and Skin Surgery Center of Indiana, P.C.

  • Dermatology Physician
  • Indianapolis, IN
  • NPI 1912030966
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1245827856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035003",
            "telephone_number": "812-932-2387",
            "fax_number": "812-222-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTHARI",
        "first_name": "ANISHA",
        "middle_name": "DURGA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-29",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003156A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Anisha.Kothari@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "415 S Landmark Ave",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474035003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ava Korinke
• Olivia Korte, RBT
• Andrew Kosak
• Michele Koselke, PSYD, HSPP
• Abhinav S Kotaru, RBT
• Georgia Faye Koushiafes, MSW LCSW
• Susan K. Kovacich, O.D.
• Taylor Koziol, RBT
• Hannah Joy Kramer, REGISTERED NURSE
• Linda S Kranitz, PHD, HSPP

• Physician Assistant in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.