CHARLES KOTULSKI MD
NPI 1902398407
Family Medicine in Tacoma, WA

Q: What is Charles Kotulski's NPI number?

The NPI number for Charles Kotulski is 1902398407. It was assigned to this individual provider in the NPPES registry on May 31, 2018.

Q: What is Charles Kotulski's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Charles Kotulski was last updated on September 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.

Active since May 31, 2018PECOS Enrolled

9040 JACKSON AVE, TACOMA, WA 98431(253) 968-3885 Get Directions Write a Review

NPPES record last updated: September 30, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 30, 2024, May 14, 2024, May 18, 2023 (3 updates tracked since 2023).

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About Charles Kotulski Md NPPES

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

CHARLES KOTULSKI MD (NPI 1902398407) is an individual family medicine provider in Tacoma, Washington, licensed in Washington (ML60863184) and active in the NPI registry since May 2018. He is enrolled in Medicare PECOS, is affiliated with Othello Community Hospital, and maintains a secondary practice location in Minocqua.

NPPES Registry Identity

NPI1902398407

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameCHARLES KOTULSKICredential: MD

Location Address9040 JACKSON AVETacoma, WA 98431-0001

Mailing Address84042 310th StMadelia, MN 56062-5417 · (507) 380-4069

Phone(253) 968-3885

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateMay 31, 2018

Last NPPES UpdateSeptember 30, 20243 updates tracked since enumeration

NPPES CertifiedSeptember 30, 2024

✔ NPI 1902398407 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WA · ML60863184

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedEmergency MedicineTaxonomy 207P00000X · License 75407-20 (WI)

9040 JACKSON AVE, Tacoma, WA 98431

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Secondary Practice Location 1

Location 19576 Hwy 70Minocqua, WI 54548-9067 · Phone (715) 234-6291

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Charles Kotulski Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID547517617

PECOS Enrollment IDI20250908000152

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Othello Community Hospital

Critical Access Hospitals · Othello, WA

OwnershipGovernment - Local

CMS Certification Number501318

Location315 North 14th AvenueOthello, WA 99344 · Adams County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98431 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

$88.29 typical visit price

range $57.27 – $172.80

Typical copayment $22.07 (range $14.31 – $43.20)

Most-billed visit code 99203

Established Patient

$100.78 typical visit price

range $18.56 – $141.11

Typical copayment $25.19 (range $4.64 – $35.27)

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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$14.56 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers15 claims15 services$76.39 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

MICHAEL JOHN MEANS CRNA

Nurse Anesthetist, Certified Registered