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DR. MICHAEL KOTLICKY O.D.
NPI 1093889024
Optometrist - Vision Therapy in Columbia, MD

Active since November 20, 2006Opted out of Medicare · through Apr 1, 2028
8827 COLUMBIA 100 PKWY STE 3, THE SIGNATURE CENTRE, COLUMBIA, MD 21045(410) 730-5808(410) 730-5893 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Michael Kotlicky O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MICHAEL KOTLICKY O.D. (NPI 1093889024) is an individual vision therapy provider in Columbia, Maryland, licensed in Maryland (TA0750) and active in the NPI registry since November 2006. He has opted out of Medicare through April 1, 2028.

NPPES Registry Identity

NPI1093889024
Entity TypeIndividualMale
Primary Taxonomy152WV0400X
Provider Legal NameDR. MICHAEL KOTLICKYCredential: O.D.
Location Address8827 COLUMBIA 100 PKWY STE 3, THE SIGNATURE CENTREColumbia, MD 21045-2178
Mailing Address8827 Columbia 100 Pkwy Ste 3, The Signature CentreColumbia, MD 21045-2178 · (410) 730-5808 · Fax (410) 730-5893
Phone(410) 730-5808
Fax(410) 730-5893
Sole ProprietorNo
Enumeration DateNovember 20, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1093889024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometrist · Vision TherapyEye and Vision Services Providers
Taxonomy Code152WV0400X
License✔ Licensed in MD · TA0750
Definition
Optometrists who specialize in vision therapy as a treatment process used to improve vision function. It includes a broad range of developmental and rehabilitative treatment programs individually prescribed to remediate specific sensory, motor and/or visual perceptual dysfunctions.
8827 COLUMBIA 100 PKWY STE 3, Columbia, MD 21045
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Michael Kotlicky O.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2020 through April 1, 2028.

Opt-Out Effective DateApril 1, 2020
Opt-Out In Effect ThroughApril 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21045 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$139.05 typical visit price
range $60.73 – $183.44
Typical copayment $34.76 (range $15.18 – $45.86)
Most-billed visit code 99204
Established Patient
$75.47 typical visit price
range $19.60 – $149.17
Typical copayment $18.86 (range $4.90 – $37.29)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Kotlicky's NPI number?

The NPI number for Michael Kotlicky is 1093889024. It was assigned to this individual provider in the NPPES registry on November 20, 2006.

Where is Michael Kotlicky located?

Michael Kotlicky practices at 8827 Columbia 100 Pkwy Ste 3 The Signature Centre, Columbia, MD 21045. The listed phone number is (410) 730-5808.

What is Michael Kotlicky's specialty?

The primary specialty registered for this NPI is Optometrist, specializing in Vision Therapy, with taxonomy code 152WV0400X.

Is Michael Kotlicky enrolled in Medicare?

No. Michael Kotlicky has opted out of Medicare through April 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Michael Kotlicky was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.