Vincent J Koletar, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD18845 Issued in OR

Practice address

2478 13TH St SE
Salem, OR 97302-2546

Phone

(503) 362-2481

Fax

(503) 371-7803

NPI assigned

Sep 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: vincekoletar@direct.wvp.nextgenshare.com

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1891780342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2478 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022546",
            "telephone_number": "503-362-2481",
            "fax_number": "503-371-7803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2478 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022546",
            "telephone_number": "503-362-2481",
            "fax_number": "503-371-7803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLETAR",
        "first_name": "VINCENT",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD18845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133940",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Koc, D.C.
• Cynthia Marie Koch, OTR/L
• Linda Kay Koehn, PHARMD
• Erik Kokkonen, M.D.
• Callie Kolb, MS CCC-SLP
• Theresa Ann Kollars, LPC
• Derek Koller, M.D.
• Alexandria Mary Kolody, LPN
• Laslo Emory Kolta, M.D.
• Lawrence Konick, MD

• Pediatrics Physician in Salem, OR
• Providers in Salem, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.