Individual provider Active NPI

Katrina Kotkowski, FNP-BC

  • Nurse Practitioner
  • Burlington, MA
National Provider Identifier
1790283349
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2292101 Issued in MA
Practice address
181 Cambridge St
Burlington, MA 01803-2922
Phone
(781) 730-0045
NPI assigned
Jan 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2292101 MA Primary

Addresses

Primary practice location

181 Cambridge St
Burlington, MA 01803-2922

Mailing address

360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190214001778 MA Practitioner - Nurse Practitioner 6800134958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians

Practice addresses (Care Compare)

35 Storey Ave
Newburyport, MA 01950-1878
Phone (978) 225-6607

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Convenientmd - FFS UC LLC CurrentSince Sep 30, 2023 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Sep 30, 2023 Accepting new patients
Convenientmd - FFS UC LLC Current Accepting new patients
Carecentral Urgent Care Medical Group PC Past Accepting new patients
Convenientmd LLC PastSince Dec 30, 2019 Accepting new patients
Convenientmd - FFS UC LLC Past Accepting new patients
Convenientmd LLC Past Accepting new patients

Locations

245 Hartford Ave
Bellingham, MA 02019
Phone (774) 295-4355

181 Cambridge St
Burlington, MA 01803
Phone (781) 730-0045

40 Davis Straits
Falmouth, MA 02540
Phone (774) 255-3010

35 Storey Ave
Newburyport, MA 01950
Phone (978) 225-6607

111 New Hampshire Ave
Portsmouth, NH 03801

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

Organizations & group practices 7

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": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1790283349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 CAMBRIDGE ST",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018032922",
            "telephone_number": "781-730-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTKOWSKI",
        "first_name": "KATRINA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-29",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2292101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.