Individual provider Active NPI

Michael Dean Kotler, MD

  • Emergency Medicine Physician
  • Harahan, LA
National Provider Identifier
1760473375
Registry record updated Aug 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
08650R Issued in LA
Practice address
1525 Dickory Ave
Harahan, LA 70123-2168
Phone
(504) 818-0006
Fax
(504) 818-0095
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 08650R LA Primary

Addresses

Primary practice location

1525 Dickory Ave
Harahan, LA 70123-2168

Mailing address

1525 Dickory Ave
Harahan, LA 70123-2168
Phone (504) 818-0006

Other identifiers 1

IdentifierTypeStateIssuer
1916633MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20110308000525 LA Practitioner - Emergency Medicine 6901822329 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pelican State Industrial Medicine Inc ApmcGroup PAC ID 4284613613, 5 clinicians

Practice addresses (Care Compare)

1525 Dickory Ave
Harahan, LA 70123-2168
Phone (504) 818-0006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
08650RLAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pelican State Industrial Medicine Inc Apmc CurrentSince Aug 23, 2000 Accepting new patients
Plaquemines Primary Care, Inc. CurrentSince Apr 15, 2010 Accepting new patients
Hospital Service District No. 1 of Plaquemines Parish CurrentSince May 1, 1991 Accepting new patients
Remotemd LLC Current Accepting new patients
Remote MD Texas PLLC Emergency Medicine Current Accepting new patients

Locations

8712 Highway 23
Belle Chasse, LA 70037
Phone (504) 226-2550

1525 Dickory Ave
New Orleans, LA 70123
Phone (504) 818-0006

27136 Highway 23
Ste A
Port Sulphur, LA 70083
Phone (504) 564-0848

27136 Highway 23
Port Sulphur, LA 70083
Phone (504) 392-7000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19414/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282867200000",
    "number": "1760473375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 DICKORY AVE",
            "city": "HARAHAN",
            "state": "LA",
            "postal_code": "701232168",
            "telephone_number": "504-818-0006",
            "fax_number": "504-818-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 DICKORY AVE",
            "city": "HARAHAN",
            "state": "LA",
            "postal_code": "701232168",
            "telephone_number": "504-818-0006",
            "fax_number": "504-818-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTLER",
        "first_name": "MICHAEL",
        "middle_name": "DEAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2010-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "08650R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1916633",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harahan, LA

Sources for this page

Verify at the official NPI Registry.