Mikhail Kotlov, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

25MA08410200 Issued in NJ

Practice address

1 Kalisa Way
Suite 210
Paramus, NJ 07652

Phone

(201) 447-0013

Fax

(201) 255-4515

NPI assigned

Jan 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

NephrologyAlso: Internal Medicine

Education

Albert Einstein College of Medicine of Yeshiva University, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bergen Hypertension and Renal AssocGroup PAC ID 0749249720, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• DaVita Radburn Dialysis Dialysis facility, Fair Lawn, NJ, CCN 312637
• DaVita Hackensack Dialysis Dialysis facility, Maywood, NJ, CCN 312615
• Valley Hospital Hospital, Paramus, NJ, CCN 310012
• Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001

Merit-based Incentive Payment System (MIPS)

Final score

95.05 of 100Reported as apm

Quality

85.71

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Bergen Hypertension & Renal Assoc

  • Nephrology Physician
  • Paramus, NJ
  • NPI 1023152980

  Internal Medicine, NJ

  Medicare reassignment Care Compare group NPD

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

• Caverns Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fair Lawn, NJ
  • NPI 1104258029

  Dialysis facility

  Care Compare affiliation Name & address match
• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Maywood, NJ
  • NPI 1932477130

  Dialysis facility

  Care Compare affiliation Name & address match
• HMH Hospitals Corporation

  • General Acute Care Hospital
  • Hackensack, NJ
  • NPI 1457456279

  Hospital

  Care Compare affiliation
• HMH Hospitals Corporation

  • Clinical Medical Laboratory
  • Hackensack, NJ
  • NPI 1518683929

  Hospital

  Care Compare affiliation
• The Valley Hospital Inc.

  • General Acute Care Hospital
  • Paramus, NJ
  • NPI 1013912633

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1891840872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KALISA WAY",
            "address_2": "SUITE 210",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "07652",
            "telephone_number": "201-447-0013",
            "fax_number": "201-255-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KALISA WAY",
            "address_2": "SUITE 210",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "07652",
            "telephone_number": "201-447-0013",
            "fax_number": "201-255-4515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTLOV",
        "first_name": "MIKHAIL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2023-10-04",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "238660",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA08410200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert J. Korst, MD
• Barbara Kosa, RD, IBCLC
• Shanthie Elizabeth Koshy-Thomas, RPA-C
• Ron Koshy
• Jill Kossove, P.A.
• Shiva Kumar Kotturi, M.D.
• Georgios Kotzias, DPM
• Angela Koza
• Arieta Kraja, PA-C
• Radu Kramer, MD

• All providers in Paramus, NJ
• Nephrology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.