Matthew Jacob Kotlove, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

54040 Issued in KY

Practice address

1 Medical Village Dr
Edgewood, KY 41017-3403

Phone

(859) 301-4000

Fax

(859) 301-4001

NPI assigned

Mar 29, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

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 2

Specialty

Hematology/Oncology

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Elizabeth Medical Center, IncGroup PAC ID 0648174623, 187 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035
• St Elizabeth Dearborn Hospital Hospital, Lawrenceburg, IN, CCN 150086
• St Elizabeth Florence Hospital, Florence, KY, CCN 180045
• St Elizabeth Ft Thomas Hospital, Fort Thomas, KY, CCN 180001
• St Elizabeth Grant Hospital, Williamstown, KY, CCN 181311

Merit-based Incentive Payment System (MIPS)

Final score

93.01 of 100Reported as apm

Quality

86.02

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkotlove329762@direct-prd.stelizabeth.com

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.

• St Elizabeth Medical Center, Inc

  • Physician Assistant
  • Erlanger, KY
  • NPI 1932187937

  IN, Internal Medicine

  Medicare reassignment Care Compare group NPD
• St Elizabeth Medical Center, Inc

  • Community/Retail Pharmacy
  • Florence, KY
  • NPI 1104699453
  NPD

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

• St Elizabeth Medical Center, Inc

  • Critical Access Hospital
  • Williamstown, KY
  • NPI 1114974813
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Florence, KY
  • NPI 1154365062
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Edgewood, KY
  • NPI 1467492421
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Fort Thomas, KY
  • NPI 1740221795
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Lawrenceburg, IN
  • NPI 1326142498
  Care Compare affiliation

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

{
    "created_epoch": "1396051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1821416645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636324",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636324",
            "telephone_number": "859-301-4000",
            "fax_number": "859-301-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "859-301-4000",
            "fax_number": "859-301-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTLOVE",
        "first_name": "MATTHEW",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-29",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.024319",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": "35.130665",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.130665",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "KY",
            "license": "54040",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "KY",
            "license": "54040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina M Kopras, MSN, RN, CNL FNP
• Aryn Korell, RBT
• Melissa Raquel Koski, RBT
• Konstantinos Kossidas, M.D
• Tushar G Kothari, MD
• Melissa Mae Kouns, M.D.
• Carla Jane Kramer, PT
• Troy James Kramer, DMD
• Brent Joseph Kraus, DPT
• Jerome Arthur Kraus, MPT

• Hematology & Oncology Physician in Edgewood, KY
• Providers in Edgewood, KY by specialty
• Hematology & Oncology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.