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CHARLES KOTULSKI MD
NPI 1902398407
Family Medicine in Tacoma, WA

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: October 25, 2026.

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

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 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
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
Open in Google Maps ↗

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 Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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

8

Medicare enrollment records show Charles Kotulski reassigns Medicare billing to 8 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Grant County Public Hospital District 3
142 mi
Emergency Medical Services
200 NAT WASHINGTON WAY
Ephrata, WA 98823
  • Reassigned Medicare billing, Washington enrollment
  • Medicare enrollment name: Grant County Public Hospital District No. 3
  • 144 clinicians in this Medicare group
NPI 1134283930 (509) 754-4631
Adams County Public Hospital District 3
162 mi
Critical Access
315 N 14TH AVE
Othello, WA 99344
  • Reassigned Medicare billing, Washington enrollment
  • 21 clinicians in this Medicare group
NPI 1811108822 (509) 331-2664
Lakeview Medical Center Inc Of Rice Lake
1,468 mi
Clinic/Center
1700 W STOUT ST
Rice Lake, WI 54868
  • Reassigned Medicare billing, Wisconsin enrollment
  • 1,616 clinicians in this Medicare group
NPI 1093201832 (715) 236-6133
Mchs Hospitals Inc
1,494 mi
Clinic/Center
2310 CRAIG RD
Eau Claire, WI 54701
  • Reassigned Medicare billing, Wisconsin enrollment
  • Also billed through NPI 1952890873 (Wisconsin)
  • 2,476 clinicians in this Medicare group
NPI 1316416035 (715) 858-8100
Flambeau Hospital Inc
1,522 mi
Clinic/Center
98 SHERRY AVE
Park Falls, WI 54552
  • Reassigned Medicare billing, Wisconsin enrollment
  • Also billed through NPI 1700963048 (Wisconsin)
  • 1,351 clinicians in this Medicare group
NPI 1194317966 (715) 762-2484
Memorial Hospital Inc
1,541 mi
Clinic/Center
N3708 RIVER AVE
Neillsville, WI 54456
  • Reassigned Medicare billing, Wisconsin enrollment
  • Also billed through NPI 1346239373 (Wisconsin)
  • 1,440 clinicians in this Medicare group
NPI 1033701800 (715) 743-3101
Marshfield Clinic Inc
1,559 mi
Clinic/Center
1000 N OAK AVE
Marshfield, WI 54449
  • Reassigned Medicare billing, Wisconsin enrollment
  • 2,540 clinicians in this Medicare group
NPI 1952347981 (715) 387-5511
Beaver Dam Community Hosptials Inc
1,643 mi
Family Medicine
1580 W JAMES ST
Columbus, WI 53925
  • Reassigned Medicare billing, Wisconsin enrollment
  • Medicare enrollment name: Beaver Dam Community Hospitals Inc.
  • 1,447 clinicians in this Medicare group
NPI 1275833659 (920) 350-0235

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 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
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-2235
DR. ADAM CLAY PERKINS PH.D.
Psychologist (Clinical)
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-3071
GABRIELLE ABRAHAMSEN DPT
Physical Therapist
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-2220
KENNY VAN LE MD
Anesthesiology
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-1110
MR. ANDREW J IRIZARRY DNP, CRNA
Nurse Anesthetist, Certified Registered
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (330) 509-3934
MATTHEW LIBID CRNA
Nurse Anesthetist, Certified Registered
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (203) 768-5053
DR. SALEEM M CHOUDRY
General Practice
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-2462
COURTNEY LAVIN
General Practice
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-1790

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 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.

Where is Charles Kotulski located?

Charles Kotulski practices at 9040 Jackson Ave, Tacoma, WA 98431. The listed phone number is (253) 968-3885.

What is Charles Kotulski's specialty?

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

Is Charles Kotulski enrolled in Medicare?

Yes. Charles Kotulski is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Charles Kotulski's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Charles Kotulski reassigns Medicare benefits to 8 organizations: Grant County Public Hospital District 3 (Ephrata, WA), Adams County Public Hospital District 3 (Othello, WA), Lakeview Medical Center Inc Of Rice Lake (Rice Lake, WI), Mchs Hospitals Inc (Eau Claire, WI), Flambeau Hospital Inc (Park Falls, WI) and 3 more organizations, listed in the Medicare section above. 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 Charles Kotulski's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Charles Kotulski accept?

Health plans from Sanford Health Plan list Charles Kotulski 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 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 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.