Brett Robert Kockentiet, MD

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

35.093291 Issued in OH

Practice address

650 Shawan Falls Dr
Dublin, OH 43017-2100

Phone

(614) 764-1711

Fax

(614) 889-2652

NPI assigned

May 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Micrographic Dermatologic Surgery (MDS)

Education

Wright State University Boonshoft School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Affiliated Dermatology and Cosmetic Surgery Center, Inc.Group PAC ID 7012993777, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

78.06 of 100Reported as group

Quality

75.48

Improvement activities

40

Cost

59.58

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brk@affiliateddermatology.emadirect.md

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.

• Affiliated Dermatology & Cosmetic Surgery Center, Inc

  • Dermatology Physician
  • Dublin, OH
  • NPI 1932184090
  Medicare reassignment Care Compare group NPD
• Affiliated Ambulatory Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Dublin, OH
  • NPI 1982696894
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1306056171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 SHAWAN FALLS DR",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430172100",
            "telephone_number": "614-764-1711",
            "fax_number": "614-889-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 SHAWAN FALLS DR",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430172100",
            "telephone_number": "614-764-1711",
            "fax_number": "614-889-2652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 Rush Ave",
            "address_purpose": "LOCATION",
            "city": "Bellefontaine",
            "state": "OH",
            "postal_code": "433119488",
            "country_code": "US",
            "telephone_number": "614-764-1711",
            "fax_number": "614-889-2652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCKENTIET",
        "first_name": "BRETT",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35.093291",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "OH",
            "license": "35.093291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GRP ID",
            "identifier": "1351",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "00744474",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Knott
• Anne Frances Knotts, LSW
• Jacqueline Deanna Knowles, OTR, CCM
• La'Niece Knowles
• Heather Brynn Koch, MA CCC-SLP
• Roxanna Kodger
• Bela Koe-Krompecher, LISW-S
• Cassandra Koechling
• Cynthia Anne Koenig, PAC
• Mark Koenig

• MOHS-Micrographic Surgery Physician in Dublin, OH
• Providers in Dublin, OH by specialty
• MOHS-Micrographic Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.