Individual provider Active NPI

Kirit K Kothari, M.D.

  • Family Medicine Physician
  • Broheadsville, PA
National Provider Identifier
1538331723
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
050895L Issued in PA
Practice address
RT 115 & Switzgable Rd
Broheadsville, PA 18322-0637
Phone
(570) 992-1234
Fax
(570) 992-8610
NPI assigned
Mar 27, 2008
Last updated
Feb 29, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 050895L PA
Dermatology Physician 207N00000X 050895L PA
Family Medicine Physician 207Q00000X 050895L PA Primary
Pain Medicine Physician 208VP0000X 050895L PA

Addresses

Primary practice location

RT 115 & Switzgable Rd
Broheadsville, PA 18322-0637

Mailing address

PO Box 637
Brodheadsville, PA 18322-0637
Phone (570) 992-1234

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080430000517 PA Practitioner - Family PracticePractitioner - AnesthesiologyPractitioner - DermatologyPractitioner - Interventional Pain Management 9436238524

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
050895LPAMDPain Medicine (Anesthesiology) Physician

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1538331723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 637",
            "city": "BRODHEADSVILLE",
            "state": "PA",
            "postal_code": "183220637",
            "telephone_number": "570-992-1234",
            "fax_number": "570-992-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RT 115 & SWITZGABLE RD",
            "city": "BROHEADSVILLE",
            "state": "PA",
            "postal_code": "183220637",
            "telephone_number": "570-992-1234",
            "fax_number": "570-992-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTHARI",
        "first_name": "KIRIT",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-27",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "PA",
            "license": "050895L",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "050895L",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "050895L",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "PA",
            "license": "050895L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.