REVATHI KOTLA MD PC
NPI 1609343672
Internal Medicine - Nephrology in West Orange, NJ
About Revathi Kotla Md Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REVATHI KOTLA MD PC (NPI 1609343672) is a healthcare organization registered as a nephrology in West Orange, New Jersey and active in the NPI registry since October 2018. The organization lists Revathi Kotla, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Revathi Kotla Md Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Revathi Kotla MD PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Revathi Kotla MD PC's NPI number?
The NPI number for Revathi Kotla MD PC is 1609343672. It was assigned to this organization in the NPPES registry on October 29, 2018.
Where is Revathi Kotla MD PC located?
Revathi Kotla MD PC is located at 623 Eagle Rock Ave, West Orange, NJ 07052. The listed phone number is (973) 736-0687.
What is Revathi Kotla MD PC's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.
Is Revathi Kotla MD PC enrolled in Medicare?
Yes. Revathi Kotla MD PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Revathi Kotla MD PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nephrology) reassigns their Medicare billing to Revathi Kotla MD PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Revathi Kotla MD PC was last updated on October 29, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Revathi Kotla Md Pc · NPI 1609343672
Nephrology organization in West Orange, New Jersey. Organization record, active in the CMS NPPES registry since October 29, 2018.
## Identity
- **NPI:** 1609343672 (Entity type: Organization)
- **Enumerated:** October 29, 2018
- **Primary specialty:** Internal Medicine - Nephrology · taxonomy 207RN0300X
- **Organization subpart:** No
- **Authorized official:** Revathi Kotla, OWNER
## Practice location
- **Address:** 623 EAGLE ROCK AVE, West Orange, NJ 07052-2948
- **Phone:** (973) 736-0687
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nephrology) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 29, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1609343672) · Data from the CMS NPPES public registry.