Individual provider Active NPI

Edward H. Kotin, PHD

  • Clinical Psychologist
  • San Marcos, TX
National Provider Identifier
1689677239
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
25333 Issued in TX
Practice address
2106 Quail Run
San Marcos, TX 78666-9495
Phone
(512) 392-8105
Fax
(512) 392-2701
NPI assigned
May 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 25333 TX Primary

Addresses

Primary practice location

2106 Quail Run
San Marcos, TX 78666-9495

Mailing address

2106 Quail Run
San Marcos, TX 78666-9495
Phone (512) 392-8105

Other identifiers 2

IdentifierTypeStateIssuer
00040GROtherTXBLUECROSS BLUESHIELD
217727OtherTXMHN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041015000745 TX Practitioner - Clinical Psychologist 7315907136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kotin Psychology PLLCGroup PAC ID 4789840232, 2 clinicians

Practice addresses (Care Compare)

2106 Quail Run
San Marcos, TX 78666-9495
Phone (512) 392-8106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25333TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kotin Psychology, PLLC Clinical CurrentSince Apr 30, 2012 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1689677239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 QUAIL RUN",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786669495",
            "telephone_number": "512-392-8105",
            "fax_number": "512-392-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 QUAIL RUN",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786669495",
            "telephone_number": "512-392-8105",
            "fax_number": "512-392-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTIN",
        "first_name": "EDWARD",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "25333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "00040GR",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "217727",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, TX

Sources for this page

Verify at the official NPI Registry.