Individual provider Active NPI

Jason Kotzin, PA-C

  • Surgical Physician Assistant
  • Spartanburg, SC
National Provider Identifier
1417817339
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
1330 Boiling Springs Rd Ste 1600
Spartanburg, SC 29303-4219
Phone
(864) 237-1453
NPI assigned
Nov 13, 2025
Last updated
Jan 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary
Student in an Organized Health Care Education/Training Program 390200000X SC

Addresses

Primary practice location

1330 Boiling Springs Rd Ste 1600
Spartanburg, SC 29303-4219

Mailing address

1330 Boiling Springs Rd Ste 1600
Spartanburg, SC 29303-4219
Phone (864) 327-1453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260224003645 SC Practitioner - Physician Assistant 1052892486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1330 Boiling Springs Rd
Suite 1600
Spartanburg, SC 29303-4219
Phone (864) 582-6396

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6232SCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Orthopaedic and Neurosurgical Associates CurrentSince Feb 2, 2026 Accepting new patients
Carolina Orthopaedic and Neurosurgical Associates Surgical CurrentSince Feb 2, 2026 Accepting new patients

Locations

115 Deacon Tiller Ct
Duncan, SC 29334
Phone (864) 582-6396

1330 Boiling Springs Rd
Ste 1600
Spartanburg, SC 29303
Phone (864) 582-6396

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1762992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1417817339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 BOILING SPRINGS RD STE 1600",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034219",
            "telephone_number": "864-327-1453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 BOILING SPRINGS RD STE 1600",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034219",
            "telephone_number": "864-237-1453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTZIN",
        "first_name": "JASON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-13",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.