| Dr Petio Vladimirov Kotov, MD | |
|
111 Colchester Ave, Burlington, VT 05401-1473 | |
| (802) 847-0000 | |
| Not Available |
| Full Name | Dr Petio Vladimirov Kotov |
|---|---|
| Gender | Male |
| Speciality | Pathology |
| Experience | 16 Years |
| Location | 111 Colchester Ave, Burlington, Vermont |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790731651 | NPI | - | NPPES |
| 0829560001 | Other | MI | MEDICARE DME |
| 4968078 | Medicaid | MI | |
| PK087243 | Other | MI | BLUE CROSS STATE ID |
| 0C16002 | Other | MI | MEDICARE GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 4301087243 (Michigan) | Secondary |
| 207ZC0500X | Pathology - Cytopathology | 042-0015453 (Vermont) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Up Health System Portage | Hancock, MI | Hospital |
| Fhn Memorial Hospital | Freeport, IL | Hospital |
| Aspirus Keweenaw Hospital And Clinics | Laurium, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Portage Hospital Llc | 1951538883 | 3 |
| Aspirus Keweenaw | 8123912011 | 74 |
| Freeport Memorial Hospital | 8426958232 | 101 |
| Entity Name | Aspirus Iron River Hospital & Clinics Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1497750830 PECOS PAC ID: 5294648929 Enrollment ID: O20031110000264 |
| Entity Name | Aspirus Ironwood Hospital & Clinics Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992704753 PECOS PAC ID: 9032013198 Enrollment ID: O20031121000096 |
| Entity Name | Aspirus Keweenaw |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205998713 PECOS PAC ID: 8123912011 Enrollment ID: O20040211000763 |
| Entity Name | Mymichigan Medical Center Saginaw |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326658154 PECOS PAC ID: 6305737156 Enrollment ID: O20040326000404 |
| Entity Name | Portage Physician Practices Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225461684 PECOS PAC ID: 6103053509 Enrollment ID: O20131210001058 |
| Entity Name | Portage Hospital Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245667229 PECOS PAC ID: 1951538883 Enrollment ID: O20140224000087 |
| Entity Name | Acquisition Bell Hospital Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699101345 PECOS PAC ID: 3971730987 Enrollment ID: O20140311000227 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Petio Vladimirov Kotov, MD 500 Campus Dr., Hancock, MI 49930-1569 Ph: (906) 048-3100 | Dr Petio Vladimirov Kotov, MD 111 Colchester Ave, Burlington, VT 05401-1473 Ph: (802) 847-0000 |
Dr. Laura Aman Greene, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 111 Colchester Ave, Ep-2-113, Burlington, VT 05401 Phone: 802-847-3566 Fax: 802-847-4155 | |
Dr. Pamela Cox Gibson, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 111 Colchester Ave, Burlington, VT 05401 Phone: 802-847-3989 Fax: 802-847-9644 | |
Dr. Mark K Fung, MD, PHD Pathology Medicare: Accepting Medicare Assignments Practice Location: 111 Colchester Ave, Fletcher Allen Health Care - Pathology, Burlington, VT 05401 Phone: 802-847-3000 Fax: 802-847-3509 | |
Dr. Tanner Emerson Russell Storozuk, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 111 Colchester Ave, Burlington, VT 05401 Phone: 800-847-0000 | |
Dr. Nicholas Jackson Hardin, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 111 Colchester Ave, Burlington, VT 05401 Phone: 802-847-2795 Fax: 802-847-9644 | |
Dr. Siba El Hussein, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 111 Colchester Ave, Burlington, VT 05401 Phone: 802-847-5121 | |
Ms. Allison Leigh Ciolino, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 111 Colchester Ave, Burlington, VT 05401 Phone: 802-847-5121 |