Richard M Kootman, M.D., P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

19610 Issued in AZ

Practice address

13943 N 91St Ave BLDG G
Peoria, AZ 85381-3687

Phone

(623) 561-1995

Fax

(623) 561-2446

NPI assigned

Aug 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Louisiana State University School of Medicine in New Orleans, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

20.05 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

66.83

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Richard M. Kootman M.D.,P.C.

  • Specialist
  • Peoria, AZ
  • NPI 1467634477
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1700896149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13943 N 91ST AVE BLDG G",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853813687",
            "telephone_number": "623-561-1995",
            "fax_number": "623-561-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13943 N 91ST AVE BLDG G",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853813687",
            "telephone_number": "623-561-1995",
            "fax_number": "623-561-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOTMAN",
        "first_name": "RICHARD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D., P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "19610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn A Koller, APRN, BCADM, CDE
• Anna Kondaurov
• Ben Michael Koolick, DDS
• Nathalie Koopmans
• Kylie Marie Koos, RN, BSN
• Michael S. Korn, DDS
• James S Kort, MD
• Lisa Ellen Koss, PT
• Maria Kovac
• Edward H Kowaleski, MD

• Specialist in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.