Active NPI
Yaakov D Kotlarsky, PA
- Medical Physician Assistant
- Las Vegas, NV
National Provider Identifier
1740529676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA1518
- Practice address
- 4385 N Pecos Rd Ste 140
Las Vegas, NV 89115-2105 - Phone
- (702) 657-0756
- NPI assigned
- Feb 13, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA1518 | NV | Primary |
Addresses
Primary practice location
4385 N Pecos Rd Ste 140
Las Vegas, NV 89115-2105
Mailing address
4385 N Pecos Rd Ste 140
Las Vegas, NV 89115-2105
Phone (702) 657-0756
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA1518 | NV | MD | Medical Physician Assistant |
Interoperability endpoints
- yaakov.kotlarsky@3941.securemail.prognocis.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693440000000",
"number": "1740529676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4385 N PECOS RD STE 140",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891152105",
"telephone_number": "702-657-0756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4385 N PECOS RD STE 140",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891152105",
"telephone_number": "702-657-0756"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTLARSKY",
"first_name": "YAAKOV",
"middle_name": "D",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-02-13",
"last_updated": "2023-08-31",
"certification_date": "2023-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NV",
"license": "PA1518",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.