Individual provider Active NPI

Ellen Leah Kotwas-Song, M.D.

  • Neurology Physician
  • West Nyack, NY
National Provider Identifier
1285892398
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
245914 Issued in NY
Practice address
2 Crosfield Ave
Suite 202
West Nyack, NY 10994-2226
Phone
(845) 353-4344
Fax
(845) 353-2661
NPI assigned
May 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 245914 NY Primary

Addresses

Primary practice location

2 Crosfield Ave
Suite 202
West Nyack, NY 10994-2226

Mailing address

2 Crosfield Ave
West Nyack, NY 10994-2226
Phone (845) 353-4344

Other names 1

  • Dr. Ellen Leah Kotwas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20101021000257 NY Practitioner - Neurology 1658564729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Temple University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
White Plains Medical Diagnostic Services, PCGroup PAC ID 5395918932, 95 clinicians

Practice addresses (Care Compare)

2 Crosfield Ave
Suite 202
West Nyack, NY 10994-2219
Phone (845) 353-4344

Hospital & facility affiliations

  • Nyack Hospital Hospital, Nyack, NY, CCN 330104
  • Helen Hayes Hospital Hospital, West Haverstraw, NY, CCN 330405
  • Burke Rehabilitation Hospital Inpatient rehabilitation facility, White Plains, NY, CCN 333030

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
245914NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
White Plains Medical Diagnostic Services, PC Neurology CurrentSince Oct 1, 2022 Accepting new patients

Locations

199 N Middletown Rd
Nanuet, NY 10954
Phone (845) 353-4344

160 N Midland Ave
Nyack, NY 10960
Phone (845) 348-2000

97 Route 303
Tappan, NY 10983
Phone (845) 348-2198

2 Crosfield Ave
Ste 202
West Nyack, NY 10994
Phone (845) 353-4344

41 E Post Rd
White Plains, NY 10601
Phone (914) 681-1201

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

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 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": "1211760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1285892398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CROSFIELD AVE",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109942226",
            "telephone_number": "845-353-4344",
            "fax_number": "845-353-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CROSFIELD AVE",
            "address_2": "SUITE 202",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109942226",
            "telephone_number": "845-353-4344",
            "fax_number": "845-353-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTWAS-SONG",
        "first_name": "ELLEN",
        "middle_name": "LEAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-26",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "245914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "KOTWAS",
            "middle_name": "LEAH",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Nyack, NY

Sources for this page

Verify at the official NPI Registry.