Mr Eduard Volfovitch Kotlyarov, MD - Medicare Radiology in Lapeer, MI

Mr Eduard Volfovitch Kotlyarov, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Lapeer, Michigan. His current practice location is 1375 N Main St, Lapeer, Michigan. You can reach out to his office (for appointments etc.) via phone at (810) 667-5500.

Mr Eduard Volfovitch Kotlyarov is licensed to practice in Michigan (license number 4301061744) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1851348247.

Contact Information

Mr Eduard Volfovitch Kotlyarov, MD
1375 N Main St,
Lapeer, MI 48446-1350
(810) 667-5500
Not Available



Physician's Profile

Full NameMr Eduard Volfovitch Kotlyarov
GenderMale
SpecialityRadiology - Diagnostic Radiology
Location1375 N Main St, Lapeer, Michigan
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1851348247
  • Provider Enumeration Date: 05/30/2006
  • Last Update Date: 02/06/2013
  Medicare PECOS Information:
  • PECOS PAC ID: 7911811187
  • Enrollment ID: I20031113000268

Medical Identifiers

Medical identifiers for Mr Eduard Volfovitch Kotlyarov such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1851348247NPI-NPPES
2965193MedicaidMI
300049506OtherMIRRMC
310D460020OtherMIBCBS GROUP PIN
3006399421OtherMIBCBS PIN #
CA5318OtherMIMEDICARE RR GROUP PIN
2965228MedicaidMI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2085N0904XRadiology - Nuclear Radiology 0101032700 (Virginia)Secondary
2085N0904XRadiology - Nuclear Radiology D0026059 (Maryland)Secondary
2085N0904XRadiology - Nuclear Radiology 4301061744 (Michigan)Secondary
2085N0904XRadiology - Nuclear Radiology MD11451 (District Of Columbia)Secondary
2085R0202XRadiology - Diagnostic Radiology D0026059 (Maryland)Secondary
2085R0202XRadiology - Diagnostic Radiology 0101032700 (Virginia)Secondary
2085R0202XRadiology - Diagnostic Radiology 4301061744 (Michigan)Primary
2085R0202XRadiology - Diagnostic Radiology MD11451 (District Of Columbia)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Eduard Volfovitch Kotlyarov allows following entities to bill medicare on his behalf.
Entity NameDlp Marquette Physician Practices Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1487902995
PECOS PAC ID: 9931359601
Enrollment ID: O20121016000312

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Entity NameImaging Associates Of Michigan Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1164943007
PECOS PAC ID: 9537434386
Enrollment ID: O20171005000049

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Eduard Volfovitch Kotlyarov is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Eduard Volfovitch Kotlyarov, MD
Po Box 32627,
Detroit, MI 48232-0627

Ph: (866) 744-1452
Mr Eduard Volfovitch Kotlyarov, MD
1375 N Main St,
Lapeer, MI 48446-1350

Ph: (810) 667-5500

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Radiology Doctors in Lapeer, MI

Dr. Ronald A Sparschu, MD
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 3273 Davison Rd Ste 3, Lapeer, MI 48446
Phone: 810-245-5675    Fax: 810-235-6650
Reese James, D.O.
Radiology
Medicare: Medicare Enrolled
Practice Location: 1375 N Main St, Lapeer, MI 48446
Phone: 810-667-5744    Fax: 810-667-5741
Leighton Ms Lum, DO
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 1375 N Main St, Lapeer, MI 48446
Phone: 810-667-5500    
Donna R Moyer, DO
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 1375 N Main St, Lapeer, MI 48446
Phone: 810-667-5500    

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