Individual provider Active NPI

Rajesh Kotak, M.D.

  • Surgery Physician
  • Brandon, FL
National Provider Identifier
1770721912
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME113098 Issued in FL
Practice address
517 Eichenfeld Dr Ste 106
Brandon, FL 33511-5997
Phone
(800) 991-6117
Fax
(888) 812-8191
NPI assigned
Jan 26, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology Physician 202K00000X ME113098 FL
Surgery Physician 208600000X ME113098 FL Primary

Addresses

Primary practice location

517 Eichenfeld Dr Ste 106
Brandon, FL 33511-5997

Mailing address

3820 Northdale Blvd Ste 201
Ste 201,
Tampa, FL 33624-1893
Phone (800) 991-6117

Other practice location 1

12901 Bruce B Downs Blvd
MDC 41
Tampa, FL 33612-4742
Phone (813) 844-7412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20131122000375 FL Practitioner - General Surgery 0143462259 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tarpon Springs Hospital Foundation Inc CurrentSince Oct 16, 2013 Accepting new patients
Tarpon Springs Hospital Foundation Inc Surgery CurrentSince Oct 16, 2013 Accepting new patients
Wazni, PLLC Surgery CurrentSince Jul 1, 2026 Accepting new patients
Colorado Medical Group, PLLC Surgery PastSince Jul 1, 2026 Accepting new patients

Locations

3820 Northdale Blvd
Ste 201
Tampa, FL 33624

3657 Madaca Ln
Tampa, FL 33618

1395 S Pinellas Ave
#N
Tarpon Springs, FL 34689
Phone (727) 942-5126

1501 S Pinellas Ave
Ste T
Tarpon Springs, FL 34689
Phone (727) 934-6797

1395 S Pinellas Ave
Tarpon Springs, FL 34689
Phone (727) 942-5000

16553 S US Highway 301
Wimauma, FL 33598

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1770721912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 NORTHDALE BLVD STE 201",
            "address_2": "STE 201,",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241893",
            "telephone_number": "800-991-6117",
            "fax_number": "888-812-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 EICHENFELD DR STE 106",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115997",
            "telephone_number": "800-991-6117",
            "fax_number": "888-812-8191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12901 Bruce B Downs Blvd",
            "address_2": "MDC 41",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336124742",
            "country_code": "US",
            "telephone_number": "813-844-7412",
            "fax_number": "813-974-8359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTAK",
        "first_name": "RAJESH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-26",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "FL",
            "license": "ME113098",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME113098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.