Individual provider Active NPI

Dorota Kotyra-Wright

  • Acute Care Nurse Practitioner
  • Bullhead City, AZ
National Provider Identifier
1548928286
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
268132 Issued in AZ
Practice address
2500 Caynon Rd
Bullhead City, AZ 86442
Phone
(928) 444-1491
NPI assigned
Nov 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 268132 AZ Primary
Acute Care Nurse Practitioner 363LA2100X RNP268132 AZ
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2500 Caynon Rd
Bullhead City, AZ 86442

Mailing address

2500 Caynon Rd C1
Bullhead City, AZ 86442-6723
Phone (928) 444-1491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20220216002732 AZ Practitioner - Nurse Practitioner 9436542362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bullhead City Clinic CorpGroup PAC ID 1052317575, 23 clinicians
Paragon Physical Therapy and Rehab LLCGroup PAC ID 4284902339, 87 clinicians

Practice addresses (Care Compare)

2500 Canyon Rd
Bullhead City, AZ 86442-8624

2585 Miracle Mile
Bullhead City, AZ 86442-7522

2735 Silver Creek Rd
Bullhead City, AZ 86442-7924
Phone (928) 763-2273

2755 Silver Creek Rd
Suite 111
Bullhead City, AZ 86442-8343
Phone (928) 704-7163

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.8 of 100Reported as apm
Quality
77.6
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
268132AZMDAcute Care Nurse Practitioner
RNP268132AZMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bullhead City Clinic Corp CurrentSince May 1, 2023 Accepting new patients
Bullhead City Clinic Corp CurrentSince May 1, 2023 Accepting new patients

Locations

2500 Canyon Rd
Bldg C
Bullhead City, AZ 86442
Phone (928) 444-1431

2755 Silver Creek Rd
Ste 111
Bullhead City, AZ 86442
Phone (928) 444-1491

2500 Canyon Rd
Ste C1
Bullhead City, AZ 86442
Phone (928) 444-1491

2735 Silver Creek Rd
Bullhead City, AZ 86442
Phone (520) 763-2273

5330 S Highway 95
Fort Mohave, AZ 86426
Phone (928) 788-2273

Interoperability endpoints

  • Direct secure messaging: dorota.kotyra-wright.1@1575.direct.athenahealth.com

Organizations & group practices 3

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 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": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1548928286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 CAYNON RD C1",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864426723",
            "telephone_number": "928-444-1491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 CAYNON RD",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "86442",
            "telephone_number": "928-444-1491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTYRA-WRIGHT",
        "first_name": "DOROTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-30",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "268132",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "RNP268132",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullhead City, AZ

Sources for this page

Verify at the official NPI Registry.