Individual provider Active NPI

Timur Kotlyar, M.D.

  • Diagnostic Radiology Physician
  • Tampa, FL
National Provider Identifier
1669850590
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME165058 Issued in FL
Practice address
6001 Webb Rd
Tampa, FL 33615-3241
Phone
(312) 724-8477
NPI assigned
May 12, 2015
Last updated
Mar 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 102646 GA
Diagnostic Radiology Physician 2085R0202X 34100 NH
Diagnostic Radiology Physician 2085R0202X MD28945 ME
Diagnostic Radiology Physician 2085R0202X ME165058 FL Primary
Diagnostic Radiology Physician 2085R0202X 01095395A IN
Diagnostic Radiology Physician 2085R0202X 2020-00439 NC
Diagnostic Radiology Physician 2085R0202X M-15670 ID

Addresses

Primary practice location

6001 Webb Rd
Tampa, FL 33615-3241

Mailing address

PO Box 1108
Corvallis, OR 97339-1108
Phone (805) 286-3826

Other practice location 1

489 State St
Bangor, ME 04401-6616
Phone (207) 973-7000

Other practice location 2

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-4735

Other practice location 3

2100 Erwin Road
Durham, NC 27710-1301
Phone (917) 257-9765

Other practice location 4

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3456

Other practice location 5

1100 Reid Pkwy
Richmond, IN 47374-1157
Phone (765) 935-8895

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, DC, IN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210616002955 ID Practitioner - Diagnostic Radiology 9537469341 Reassigns benefits to 12 organizations
I20250311002752 DC Practitioner - Diagnostic Radiology 9537469341 Reassigns benefits to 1 organization
I20260319003585 IN Practitioner - Diagnostic Radiology 9537469341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Radiology P CGroup PAC ID 0143295410, 101 clinicians
Pacific Imaging Associates LLCGroup PAC ID 3577923499, 69 clinicians
Henry County Memorial HospitalGroup PAC ID 6002724085, 153 clinicians
Reid Physician Associates IncGroup PAC ID 6406910769, 427 clinicians
Weiser Valley Hospital DistrictGroup PAC ID 5294704276, 60 clinicians
Boise Radiology Group PLLCGroup PAC ID 9638153257, 64 clinicians
Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians
Ella E M Brown Charitable CircleGroup PAC ID 1254228745, 172 clinicians
Greene County General HospitalGroup PAC ID 2961481544, 102 clinicians
Spectrum Healthcare Partners PAGroup PAC ID 7618871245, 305 clinicians
Gainesville Radiology Group PCGroup PAC ID 9335046382, 65 clinicians

Practice addresses (Care Compare)

Boise, ID 83703
Phone (260) 432-1568

1000 N 16TH St
New Castle, IN 47362-4319
Phone (765) 521-0890

1100 Reid Pkwy
Richmond, IN 47374-1157
Phone (765) 983-3122

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 549-0370

2456 S 60TH
Idaho Falls, ID 83406-8003
Phone (904) 399-5550

5899 W Castle Dr
Boise, ID 83703-3214
Phone (269) 781-4271

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.06 of 100Reported as group
Quality
72.79
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.94 of 100Reported as group
Quality
92.87
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME165058FLMDDiagnostic Radiology Physician
102646GAMDDiagnostic Radiology Physician
M-15670IDMDDiagnostic Radiology Physician
01095395AINMDDiagnostic Radiology Physician
MD28945MEMDDiagnostic Radiology Physician
34100NHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ella E M Brown Charitable Circle Diagnostic Radiology CurrentSince Jul 6, 2025 Accepting new patients
Summit Radiology P C Diagnostic Radiology CurrentSince Aug 17, 2025 Accepting new patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince Feb 7, 2024 Accepting new patients
Weiser Valley Hospital District CurrentSince Jul 18, 2023 Accepting new patients
Pacific Imaging Associates LLC Diagnostic Radiology CurrentSince Sep 29, 2025 Accepting new patients
Reid Physician Associates, Inc. CurrentSince May 11, 2026 Accepting new patients
Dimensions Healthcare Associates, Inc. Current Accepting new patients
Spectrum Healthcare Partners, P.a. CurrentSince Apr 1, 2025 Accepting new patients
Dimensions Health Associates Dba University of Maryland Capital Region CurrentSince Feb 1, 2025 Accepting new patients
Reid Physician Associates, Inc CurrentSince May 11, 2026 Accepting new patients
Dimensions Healthcare Associates Inc Diagnostic Radiology CurrentSince Feb 1, 2025 Accepting new patients
North Canyon Medical Center Inc. CurrentSince Jul 1, 2021 Accepting new patients
Weiser Valley Hospital District Diagnostic Radiology CurrentSince Jul 18, 2023 Accepting new patients
Spectrum Healthcare Partners, PA Diagnostic Radiology Current Accepting new patients
North Canyon Medical Center, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Spectrum Healthcare Partners, PA Diagnostic Radiology CurrentSince Apr 1, 2025 Accepting new patients
Boise Radiology Group PLLC Diagnostic Radiology CurrentSince Aug 1, 2021 Accepting new patients
Gainesville Radiology Group, PC Diagnostic Radiology CurrentSince Feb 1, 2025 Accepting new patients
Greene County General Hospital Diagnostic Radiology CurrentSince Jul 31, 2025 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations (25 of 27)

6001 Webb Rd
Twn North Cntry, FL 33615
Phone (813) 579-1402

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

100 E Idaho St
Boise, ID 83712
Phone (208) 343-3223

1000 E Park Blvd
Boise, ID 83712
Phone (208) 381-4100

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

600 N Robbins Rd
Boise, ID 83702
Phone (208) 489-4444

701 E Parkcenter Blvd
Boise, ID 83706
Phone (208) 381-6400

703 S Americana Blvd
Boise, ID 83702
Phone (208) 706-6375

3101 E State St
Eagle, ID 83616
Phone (208) 473-3100

1210 NW 16th St
Fruitland, ID 83619
Phone (208) 452-8600

267 N Canyon Dr
Gooding, ID 83330
Phone (208) 934-4433

3140 W Milano Dr
Ste 150
Meridian, ID 83646
Phone (208) 887-4775

3277 E Louise Dr
Ste 100
Meridian, ID 83642
Phone (208) 706-5217

520 S Eagle Rd
Meridian, ID 83642
Phone (208) 706-5000

895 N 6th E
Mtn Home, ID 83647
Phone (208) 580-2661

9850 W St Lukes Dr
Nampa, ID 83687
Phone (208) 205-7282

645 E 5th St
Weiser, ID 83672
Phone (208) 549-0370

1185 N 1000 W
Linton, IN 47441
Phone (812) 847-2281

1000 N 16th St
New Castle, IN 47362
Phone (765) 521-0890

1100 Reid Pkwy
Richmond, IN 47374
Phone (765) 983-3000

2900 Mercy Ln
Cheverly, MD 20785
Phone (301) 618-2010

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

901 Harry S Truman Dr N
Uppr Marlboro, MD 20774
Phone (240) 677-0021

489 State St
Bangor, ME 04401
Phone (207) 973-8837

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 41

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1669850590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1108",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391108",
            "telephone_number": "805-286-3826",
            "fax_number": "805-221-6843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 WEBB RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336153241",
            "telephone_number": "312-724-8477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "489 State St",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "044016616",
            "country_code": "US",
            "telephone_number": "207-973-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22 Bramhall St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023134",
            "country_code": "US",
            "telephone_number": "207-662-4735",
            "fax_number": "207-662-6388",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Erwin Road",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277101301",
            "country_code": "US",
            "telephone_number": "917-257-9765",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Atwell Rd",
            "address_purpose": "LOCATION",
            "city": "Cooperstown",
            "state": "NY",
            "postal_code": "133261301",
            "country_code": "US",
            "telephone_number": "607-547-3456",
            "fax_number": "607-547-6612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Reid Pkwy",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "IN",
            "postal_code": "473741157",
            "country_code": "US",
            "telephone_number": "765-935-8895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTLYAR",
        "first_name": "TIMUR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-12",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "102646",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NH",
            "license": "34100",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ME",
            "license": "MD28945",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME165058",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01095395A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2020-00439",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M-15670",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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Sources for this page

Verify at the official NPI Registry.