Active NPI
Gregory Raphael Kotnis, MD
- Anatomic Pathology & Clinical Pathology Physician
- Denver, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- DR.0050096
- Practice address
- 6116 E Warren Ave
Denver, CO 80222-5703 - Phone
- (303) 512-2299
- NPI assigned
- Jan 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 0101252050 | VA | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | DR.0050096 | CO | Primary |
Addresses
Primary practice location
6116 E Warren Ave
Denver, CO 80222-5703
Mailing address
6116 E Warren Ave
Denver, CO 80222-5703
Phone (303) 512-2299
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | VA | |
| 99158752 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pathology
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2157 Main St
Buffalo, NY 14214-2648
Phone (716) 862-1769
2605 Harlem Rd
Cheektowaga, NY 14225-4018
Phone (716) 891-2400
2950 Elmwood Ave
Kenmore, NY 14217-1304
Phone (716) 447-8237
565 Abbott Rd
Buffalo, NY 14220-2039
Phone (716) 828-2401
Hospital & facility affiliations
- Mercy Hospital of Buffalo
- Sisters of Charity Hospital
- Mount St. Mary'S Hospital & Health Center
- Kenmore Mercy Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0050096 | CO | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastern Great Lakes Pathology PC | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
Locations
20 Northpointe Pkwy
Ste 130
Buffalo, NY 14228
2950 Elmwood Ave
Tonawanda, NY 14217
Phone (716) 447-6100
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.
-
- Anatomic Pathology & Clinical Pathology Physician
- Buffalo, NY
- NPI 1467481564
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Kenmore, NY
- NPI 1770598104
-
- General Acute Care Hospital
- Buffalo, NY
- NPI 1164464921
-
- General Acute Care Hospital
- Lewiston, NY
- NPI 1043394745
-
- General Acute Care Hospital
- Cheektowaga, NY
- NPI 1043455199
-
- General Acute Care Hospital
- Buffalo, NY
- NPI 1790727543
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443052800000",
"number": "1740336429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6116 E WARREN AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802225703",
"telephone_number": "303-512-2299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6116 E WARREN AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802225703",
"telephone_number": "303-512-2299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTNIS",
"first_name": "GREGORY",
"middle_name": "RAPHAEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-26",
"last_updated": "2015-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "VA",
"license": "0101252050",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "CO",
"license": "DR.0050096",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "99158752",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; 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.