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LISA KOTULA PMHNP
NPI 1639912298
Nurse Practitioner - Psychiatric/Mental Health in Harrison Twp, MI

Active since June 13, 2024PECOS EnrolledAccepts Medicare Assignment
25912 ASHBY DR, HARRISON TWP, MI 48045(586) 242-6623 Get Directions Write a Review

NPPES record last updated: June 13, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Lisa Kotula Pmhnp NPPES

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

LISA KOTULA PMHNP (NPI 1639912298) is an individual psychiatric/mental health provider in Harrison Twp, Michigan, licensed in Michigan (4704212792) and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1639912298
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameLISA KOTULACredential: PMHNP
Location Address25912 ASHBY DRHarrison Twp, MI 48045-3081
Mailing Address25912 Ashby DrHarrison Twp, MI 48045-3081 · (586) 242-6623
Phone(586) 242-6623
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateJune 13, 2024
NPPES CertifiedJune 13, 2024
✔ NPI 1639912298 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in MI · 4704212792
25912 ASHBY DR, Harrison Twp, MI 48045
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lisa Kotula Pmhnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID749717312
PECOS Enrollment IDI20241219004112
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Lisa Kotula reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Downriver Mental Health Clinic PC
6.3 mi
Mental Health (Including Community Mental Health Center)
24715 LITTLE MACK AVE, SUITE 200
Saint Clair Shores, MI 48080
  • Reassigned Medicare billing, Michigan enrollment
  • 451 clinicians in this Medicare group
NPI 1598893141 (586) 777-9000
Healing Mental Health PLLC
29 mi
Psychiatric/Mental Health
5770 HIGHLAND RD STE A
Waterford, MI 48327
  • Reassigned Medicare billing, Michigan enrollment
  • 7 clinicians in this Medicare group
NPI 1497470975 (248) 775-7767
Pure Psychiatry Of Michigan PLLC
33 mi
Physician Assistant
34841 VETERANS PLAZA
Wayne, MI 48184
  • Reassigned Medicare billing, Michigan enrollment
  • 131 clinicians in this Medicare group
NPI 1831701671 (313) 292-7640

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 48045 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
Most-billed visit code 99214
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 Lisa Kotula's NPI number?

The NPI number for Lisa Kotula is 1639912298. It was assigned to this individual provider in the NPPES registry on June 13, 2024.

Where is Lisa Kotula located?

Lisa Kotula practices at 25912 Ashby Dr, Harrison Twp, MI 48045. The listed phone number is (586) 242-6623.

What is Lisa Kotula's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Lisa Kotula enrolled in Medicare?

Yes. Lisa Kotula is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Lisa Kotula's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Kotula reassigns Medicare benefits to 3 organizations: Downriver Mental Health Clinic PC (Saint Clair Shores, MI), Healing Mental Health PLLC (Waterford, MI) and Pure Psychiatry Of Michigan PLLC (Wayne, MI). Each 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 Lisa Kotula's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lisa Kotula accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company, Priority Health and UnitedHealthcare list Lisa Kotula as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lisa Kotula was last updated on June 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.