NPIMap

Individual provider Active NPI

Michael Kottwitz, M.D.

  • Urology Physician
  • Evansville, IN
National Provider Identifier
1508204454
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
01085826A Issued in IN
Practice address
920 S Hebron Ave
Evansville, IN 47714-4086
Phone
(812) 473-1111
NPI assigned
Jun 12, 2013
Last updated
Jul 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 125.062756 IL
Urology Physician 208800000X 01085826A IN Primary

Addresses

Primary practice location

920 S Hebron Ave
Evansville, IN 47714-4086

Mailing address

920 S Hebron Ave
Evansville, IN 47714-4086
Phone (812) 473-1111

Other practice location 1

301 N 8th St
4B
Springfield, IL 62701-1041
Phone (217) 545-7305

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michael.kottwitz.1@7598.direct.athenahealth.com St Mary's Medical Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200911001504 KY Practitioner - Urology 9830331362 Reassigns benefits to 2 organizations
I20210618001059 IN Practitioner - Urology 9830331362 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Southern Illinois University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians

Practice addresses (Care Compare)

151 N Gardenmile Rd
Henderson, KY 42420-5543
Phone (270) 830-9186

920 S Hebron Ave
Evansville, IN 47714-4086
Phone (812) 473-1111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125.062756ILMDUrology Physician
01085826AINMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Daviess County Hospital Current Accepting new patients
Daviess County Hospital Current Accepting new patients
St Mary's Medical Group, LLC CurrentSince Aug 9, 2021 Accepting new patients
Daviess County Hospital CurrentSince Jul 1, 2025 Accepting new patients
Daviess County Hospital CurrentSince Jul 1, 2025 Accepting new patients
T J Samson Community Hospital CurrentSince Sep 11, 2020 Accepting new patients
Daviess County Hospital CurrentSince Jul 1, 2025 Accepting new patients
St Mary's Medical Group, LLC CurrentSince Aug 9, 2021 Accepting new patients
Urological Associates, Inc. Urology Past Accepting new patients
St. Mary's Health, Inc Urology Past Accepting new patients

Locations

1116 Millis Ave
Boonville, IN 47601
Phone (812) 897-4800

801 Saint Marys Dr
Ste 505E
Evansville, IN 47714
Phone (812) 491-3236

920 S Hebron Ave
Evansville, IN 47714
Phone 8124731111253

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

1314 E Walnut St
Washington, IN 47501
Phone (812) 254-2250

1402 Grand Ave
Washington, IN 47501
Phone (812) 254-2250

1301 N Race St
Glasgow, KY 42141
Phone (270) 651-4141

310 N L Rogers Wells Blvd
Glasgow, KY 42141
Phone (270) 651-1111

151 N Gardenmile Rd
Henderson, KY 42420
Phone (270) 830-9186

2000 N Elm St
#2
Henderson, KY 42420
Phone (270) 831-6651

Interoperability endpoints

  • Direct secure messaging: michael.kottwitz.1@7598.direct.athenahealth.com

Organizations & group practices 10

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 6

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": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1508204454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 S HEBRON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477144086",
            "telephone_number": "812-473-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 S HEBRON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477144086",
            "telephone_number": "812-473-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 N 8th St",
            "address_2": "4B",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627011041",
            "country_code": "US",
            "telephone_number": "217-545-7305",
            "fax_number": "217-545-7305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTTWITZ",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "125.062756",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IN",
            "license": "01085826A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.kottwitz.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "920 S Hebron Ave",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477144086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.