Active NPI
Thomas G Kotoske, DO
- Plastic Surgery Physician
- Phoenix, AZ
National Provider Identifier
1861571960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 3065
- Practice address
- 19636 N 27TH Ave
#101
Phoenix, AZ 85027 - Phone
- (623) 516-2639
- Fax
- (623) 580-0019
- NPI assigned
- Nov 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology/Facial Plastic Surgery Physician | 207YX0905X | 3065 | AZ | |
| Plastic Surgery Physician | 208200000X | 3065 | AZ | Primary |
Addresses
Primary practice location
19636 N 27TH Ave
#101
Phoenix, AZ 85027
Mailing address
19636 N 27TH Ave
#101
Phoenix, AZ 85027
Phone (623) 516-2639
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 329145 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3065 | AZ | MD | Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1861571960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19636 N 27TH AVE",
"address_2": "#101",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85027",
"telephone_number": "623-516-2639",
"fax_number": "623-580-0019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19636 N 27TH AVE",
"address_2": "#101",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85027",
"telephone_number": "623-516-2639",
"fax_number": "623-580-0019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTOSKE",
"first_name": "THOMAS",
"middle_name": "G",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "207YX0905X",
"taxonomy_group": "",
"desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
"state": "AZ",
"license": "3065",
"primary": false
},
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "AZ",
"license": "3065",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "329145",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.