Amanda Marie Kotolski, PH.D, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT12215 Issued in FL

Practice address

6061 Bahia del Mar Blvd
207
St Petersburg, FL 33715-3321

Phone

(727) 637-6137

Fax

(727) 388-9640

NPI assigned

Jan 11, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Ak Therapy Inc

  • Physical Therapy Clinic/Center
  • Tampa, FL
  • NPI 1184852493
  NPD (past) Authorized official
• Amazing Kids Therapy, Inc

  • Clinic/Center
  • St Petersburg, FL
  • NPI 1609014471
  NPD (past) Authorized official

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446336000000",
    "number": "1932259017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6061 BAHIA DEL MAR BLVD",
            "address_2": "207",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337153321",
            "telephone_number": "727-637-6137",
            "fax_number": "727-388-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6061 BAHIA DEL MAR BLVD",
            "address_2": "207",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337153321",
            "telephone_number": "727-637-6137",
            "fax_number": "727-388-9640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTOLSKI",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "PH.D, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2015-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT12215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC OPTUM HEALTH",
            "identifier": "743501",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891186000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "190029",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "812350100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "Z113T",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Robert Kosydar, DDS
• Stacey Koszut, M.S., C.G.C
• David Kazimierz Koszyk, PT
• Erick Koszyk, EMT
• Nicholas A Kotch, D.O.
• Spiro Kotsios, M.A., BCBA
• Jason Kotsko, PHARMD
• John Joseph Kotula III, M.D.
• Bipan Kotwal, M.D.
• Insaf Kouba

• Occupational Therapist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.