Vsevolod Kohutiak, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD011593E Issued in PA

Practice address

1068 W Baltimore Pike
Media, PA 19063

Phone

(610) 891-3388

Fax

(610) 891-3680

NPI assigned

Mar 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Lima Gerontology Associates LLP

  • Internal Medicine Physician
  • Lima, PA
  • NPI 1013967645
  NPD
• Brodkohutiak&Jamaliltd

  • Internal Medicine Physician
  • Media, PA
  • NPI 1013092212
  NPD (past)

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199750400000",
    "number": "1366410854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 W BALTIMORE PIKE",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "19063",
            "telephone_number": "610-891-3388",
            "fax_number": "610-891-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1068 W BALTIMORE PIKE",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "19063",
            "telephone_number": "610-891-3388",
            "fax_number": "610-891-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHUTIAK",
        "first_name": "VSEVOLOD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2008-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD011593E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "0031354000",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76865780012",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madeline Rose Kling
• Elizabeth Knasiak, BS
• Alexandra Knaub
• Domenica M Knudsen
• Andrea Koban Payne, PH.D.
• Koinonia Counseling
• Gina Kokoska, MA, CCC-SLP
• Kristen Konieczny
• Amanda Koniewicz, PSY.D, LPC, CAADC
• Tricia Louise Korenkiewicz, OD

• Internal Medicine Physician in Media, PA
• Providers in Media, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.