Joseph J. Kotelnicki, PA-C
Individual provider Active NPI Surgical Physician Assistant · Pittsfield, MA
NPI 1255669552 · NPPES record last updated Mar 30, 2012
Key facts
- NPI
- 1255669552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 1727 (MA)
- Practice address
- 24 Park Street
Pittsfield, MA 01201 - Phone
- (413) 499-6600
- Fax
- (413) 442-0744
- NPI assigned
- Nov 24, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Berkshire Orthopaedic Associates Inc
Practice addresses (Care Compare)
24 Park St
Pittsfield, MA 01201-0900
Phone (413) 499-6600
Hospital & facility affiliations
- Berkshire Medical Center
- Fairview Hospital
- North Adams Regional Hospital Corporation
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100218000408 | MA | Practitioner - Physician Assistant | 7214071984 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1727 | MA | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Berkshire Orthopaedic Associates, Inc. | Current |
Accepting new patients | |
| Berkshire Orthopaedic Associates, Inc. | Current |
Accepting new patients | |
| Greater Chesapeake Orthopedics Associates, LLC | Past | Accepting new patients |
Locations
24 Park St
Pittsfield, MA 01201
Phone (413) 499-6600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 1727 | MA | Yes |
Addresses
Primary practice location
24 Park Street
Pittsfield, MA 01201
Mailing address
24 Park Street
Pittsfield, MA 01201
Phone (413) 499-6600
Other providers in Pittsfield, MA
- Albert Abban Koomson
- Kelly Koperek
- Nicole S Kordana
- Eric S. Korenman
- Christina M Korney
- Tamara Kovac
- Deborah Kovitz
- Karyn Koziara
- Kelly Kozik
- Marzena Zofia Kozik
All providers in Pittsfield, MA · Surgical Physician Assistant in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 30, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.