Individual provider Active NPI

Robert S. Kotula, CRNA

  • Certified Registered Nurse Anesthetist
  • Albany, NY
National Provider Identifier
1467451997
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
435011 Issued in NY
Practice address
1450 Western Ave Ste 102
Anesthesia Group of Albany, PC
Albany, NY 12203-3539
Phone
(518) 463-0050
Fax
(518) 207-2973
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 435011 NY Primary

Addresses

Primary practice location

1450 Western Ave Ste 102
Anesthesia Group of Albany, PC
Albany, NY 12203-3539

Mailing address

1450 Western Ave Ste 102
Anesthesia Group of Albany, PC
Albany, NY 12203-3539
Phone (518) 463-0050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110308000157 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860674124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Albany Medical College of Union University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Group of Albany, PCGroup PAC ID 5092602458, 101 clinicians

Practice addresses (Care Compare)

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 463-0050

Hospital & facility affiliations

  • St Peter'S Hospital Hospital, Albany, NY, CCN 330057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Group of Albany, PC CurrentSince Nov 4, 2002 Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

1450 Western Ave
Ste 102
Albany, NY 12203

1375 Washington Ave
Albany, NY 12206

3 Atrium Dr
Albany, NY 12205
Phone (518) 435-1234

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 1

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1467451997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 WESTERN AVE STE 102",
            "address_2": "ANESTHESIA GROUP OF ALBANY, PC",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033539",
            "telephone_number": "518-463-0050",
            "fax_number": "518-207-2973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 WESTERN AVE STE 102",
            "address_2": "ANESTHESIA GROUP OF ALBANY, PC",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033539",
            "telephone_number": "518-463-0050",
            "fax_number": "518-207-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTULA",
        "first_name": "ROBERT",
        "middle_name": "S.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "435011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.