Individual provider Active NPI

Krista Kotzeva, D.P.M.

  • Podiatrist
  • Southfield, MI
National Provider Identifier
1730749961
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5951001356 Issued in MI
Practice address
22401 Foster Winter Dr
Southfield, MI 48075-3724
Phone
(248) 423-5100
NPI assigned
Jun 19, 2019
Last updated
Jun 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 5951001356 MI Primary

Addresses

Primary practice location

22401 Foster Winter Dr
Southfield, MI 48075-3724

Mailing address

22401 Foster Winter Dr
Southfield, MI 48075-3724
Phone (248) 423-5100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231213002235 MI Practitioner - Podiatry 7719341718 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Physical Rehabilitation IncGroup PAC ID 6901717768, 352 clinicians
Center for Physical Rehabilitation and Therapy LPGroup PAC ID 0941513303, 365 clinicians

Practice addresses (Care Compare)

1195 Wilson Ave NW
Suite 200
Grand Rapids, MI 49534-6405
Phone (616) 453-8277

5060 Cascade Rd
Suite a
Grand Rapids, MI 49546-3808

5060 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-3808

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions16
Removal of nail tissue353
Removal or shaving of skin growth71
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5951001356MIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot & Ankle Specialists of West Michigan P L L C CurrentSince Nov 1, 2024 Accepting new patients
Royalton Foot & Ankle Associates PC Podiatrist CurrentSince Dec 24, 2023 Accepting new patients
Foot & Ankle Specialists of West Michigan P L L C Podiatrist CurrentSince Nov 1, 2024 Accepting new patients

Locations

1660 Feehanville Dr
Ste 450
Mt Prospect, IL 60056
Phone (847) 250-9629

1195 Wilson Ave NW
Ste 200
Grand Rapids, MI 49534
Phone (616) 453-8277

2144 East Paris Ave SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 281-0666

1450 Farr Rd
Norton Shores, MI 49444
Phone (231) 739-7606

6050 Northland Dr NE
Ste 180
Rockford, MI 49341
Phone (616) 363-9833

4035 Hollywood Rd
Saint Joseph, MI 49085
Phone (269) 428-2440

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1730749961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22401 FOSTER WINTER DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753724",
            "telephone_number": "248-423-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22401 FOSTER WINTER DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753724",
            "telephone_number": "248-423-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTZEVA",
        "first_name": "KRISTA",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5951001356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.