SIMON KOTLYAR
NPI 1629273941
Emergency Medicine in Durango, CO
About Simon Kotlyar NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SIMON KOTLYAR (NPI 1629273941) is an individual emergency medicine provider in Durango, Colorado, licensed in Colorado (52012) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Simon Kotlyar is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Simon Kotlyar reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Gresham, OR 97030
- Reassigned Medicare billing, Oregon and Washington enrollments
- Medicare enrollment name: Kaiser Foundation Health Plan Of The Northwest
- Also billed through NPI 1871848457 (Washington)
- 3,207 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 81301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
DURANGO, CO 81301
DURANGO, CO 81301
DURANGO, CO 81301
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 Simon Kotlyar's NPI number?
The NPI number for Simon Kotlyar is 1629273941. It was assigned to this individual provider in the NPPES registry on June 18, 2007. The provider is also known as Simon Kotlyar MD.
Where is Simon Kotlyar located?
Simon Kotlyar practices at 1010 Three Springs Blvd, Durango, CO 81301. The listed phone number is (303) 306-7783.
What is Simon Kotlyar's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Simon Kotlyar enrolled in Medicare?
Yes. Simon Kotlyar is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Simon Kotlyar's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Simon Kotlyar reassigns Medicare benefits to Sapphire At Gresham Rehab, LLC (Gresham, OR). The 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 Simon Kotlyar's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Simon Kotlyar was last updated on March 31, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Simon Kotlyar · NPI 1629273941
Emergency Medicine physician in Durango, Colorado. Individual provider, active in the CMS NPPES registry since June 18, 2007.
## Identity
- **NPI:** 1629273941 (Entity type: Individual)
- **Enumerated:** June 18, 2007
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 52012 (Colorado)
- **Sole proprietor:** No
## Practice location
- **Address:** 1010 THREE SPRINGS BLVD, Durango, CO 81301-8296
- **Phone:** (303) 306-7783 · **Fax:** (303) 306-7753
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Sapphire At Gresham Rehab, LLC (NPI 1033740899, Gresham, OR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 31, 2014
- **Other identifiers:** Medicare PIN 294163YLKW (CO); Medicaid 82735085 (CO)
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Source: [NPI Profile](https://npiprofile.com/npi/1629273941) · Data from the CMS NPPES public registry.