Mary W Kortan, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

50001544 Issued in OH

Practice address

850 Columbia Rd
Suite 200
Westlake, OH 44145-1493

Phone

(440) 808-1212

Fax

(440) 808-0321

NPI assigned

Jan 3, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Comprehensive Pain Care Center, Inc

  • Specialist
  • Lorain, OH
  • NPI 1124095112
  NPD (past)
• North Shore Endoscopy Center

  • Gastroenterology Physician
  • Westlake, OH
  • NPI 1467474585
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366509770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 COLUMBIA RD",
            "address_2": "SUITE 200",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441451493",
            "telephone_number": "440-808-1212",
            "fax_number": "440-808-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 COLUMBIA RD",
            "address_2": "SUITE 200",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441451493",
            "telephone_number": "440-808-1212",
            "fax_number": "440-808-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORTAN",
        "first_name": "MARY",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50001544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Jon Komitau, M.D.
• Margaret Alma Konecky, D.P.M.
• Reiley Konschak
• Robert M Konstan, M.D.
• David R Koris, D.P.M.
• Katelyn Elizabeth Kosileski, DDS
• Sophia Kosmides
• Vernaann M Kotansky
• Kimberly Kotik, LPCC
• Benjamin Martin Kotinsley, MD

• Medical Physician Assistant in Westlake, OH
• Providers in Westlake, OH by specialty
• Medical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.