Individual provider Active NPI

Michael David Kotzen, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Van Nuys, CA
National Provider Identifier
1871537340
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4686 Issued in CA
Practice address
15243 Vanowen St
Suite 411B
Van Nuys, CA 91405-3605
Phone
(818) 782-3338
Fax
(818) 782-3337
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E4686 CA Primary

Addresses

Primary practice location

15243 Vanowen St
Suite 411B
Van Nuys, CA 91405-3605

Mailing address

15243 Vanowen St
Suite 411B
Van Nuys, CA 91405-3605
Phone (818) 782-3338

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070323000364 CA Practitioner - Podiatry 5294797494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Home Foot Care IncGroup PAC ID 4981744257, 25 clinicians

Practice addresses (Care Compare)

12520 Magnolia Blvd
Suite 304
Valley Village, CA 91607-2355
Phone (818) 452-9902

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue21
Removal of nail tissue996
Removal or shaving of skin growth159

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4686CAMDFoot & Ankle Surgery Podiatrist
1710TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Home Foot Care, Inc. CurrentSince Jul 22, 2009 Accepting new patients
Lepow Podiatric Medical Associates Past Accepting new patients
Clarksville Physician Services LLC Past Accepting new patients
Valley Presbyterian Hospital Past Accepting new patients
Lepow Podiatric Medical Associates Foot & Ankle Surgery Past Accepting new patients
Home Foot Care, LLP Past Accepting new patients

Locations

12520 Magnolia Blvd
Ste 304
Valley Vlg, CA 91607
Phone (818) 452-9902

15243 Vanowen St
Ste 411B
Van Nuys, CA 91405
Phone (818) 408-2800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1879/brand/1/csg/1/fhir/r4

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281312000000",
    "number": "1871537340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15243 VANOWEN ST",
            "address_2": "SUITE 411B",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053605",
            "telephone_number": "818-782-3338",
            "fax_number": "818-782-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15243 VANOWEN ST",
            "address_2": "SUITE 411B",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053605",
            "telephone_number": "818-782-3338",
            "fax_number": "818-782-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTZEN",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2010-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.