Individual provider Active NPI

Ajoy Kotwal, MD

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1811919657
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0065983 Issued in FL
Practice address
3102 W Cypress St
Suite B
Tampa, FL 33607
Phone
(813) 874-1404
Fax
(813) 874-9305
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0065983 FL Primary

Addresses

Primary practice location

3102 W Cypress St
Suite B
Tampa, FL 33607

Mailing address

3102 W Cypress St
Suite B
Tampa, FL 33607
Phone (813) 874-1404

Other identifiers 5

IdentifierTypeStateIssuer
231261OtherFLWELLCARE
25921OtherFLBCBS
ME0065983OtherFLSTATE LIC
270102OtherFLAVMED
231261OtherFLSTAYWELL

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
I20040216001082 FL Practitioner - Internal MedicinePractitioner - Pediatric Medicine 3577458926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Consultants of Florida LLCGroup PAC ID 6002988847, 35 clinicians

Practice addresses (Care Compare)

3102 W Cypress St
Suite B
Tampa, FL 33607-5118
Phone (813) 874-1404

Hospital & facility affiliations

  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0065983FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Consultants of Florida, LLC Internal Medicine CurrentSince Feb 8, 2023 Accepting new patients
Nautilus Health Care Group, LLC Past Accepting new patients
Advanced Wound Systems LLC Past Accepting new patients
Ashok Bhat M.D. PA Internal Medicine Past Accepting new patients
Patient Medical Center of Florida Inc Internal Medicine PastSince Apr 4, 2018 Accepting new patients

Locations

819 N Central Ave
Kissimmee, FL 34741
Phone (407) 288-8242

672 SW Prima Vista Blvd
Ste 101
Port St Lucie, FL 34983
Phone (772) 905-2555

3505 E Hillsborough Ave
Ste 101
Tampa, FL 33610
Phone (813) 415-0100

3102 W Cypress St
Ste B
Tampa, FL 33607
Phone (813) 874-1404

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811919657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 W CYPRESS ST",
            "address_2": "SUITE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33607",
            "telephone_number": "813-874-1404",
            "fax_number": "813-874-9305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 W CYPRESS ST",
            "address_2": "SUITE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33607",
            "telephone_number": "813-874-1404",
            "fax_number": "813-874-9305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTWAL",
        "first_name": "AJOY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0065983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "231261",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "25921",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC",
            "identifier": "ME0065983",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "270102",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAYWELL",
            "identifier": "231261",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.