| Shawn Michael Kotlyn, CRNA | |
|
1414 Honeygold Ln, Broadview Heights, OH 44147-3630 | |
| (440) 570-4022 | |
| Not Available |
| Full Name | Shawn Michael Kotlyn |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 29 Years |
| Location | 1414 Honeygold Ln, Broadview Heights, Ohio |
| 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 |
|---|---|---|---|
| 1619991031 | NPI | - | NPPES |
| 2287583 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RN268118 / NA06661 (Ohio) | Primary |
| 367500000X | Nurse Anesthetist, Certified Registered | RN572172 (Pennsylvania) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Grand Lake Health System | Saint marys, OH | Hospital |
| Summa Health System | Akron, OH | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Dayton Anesthesia And Pain Services Llc | 8022245372 | 225 |
| Entity Name | Anesthesiology Services Network Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821076779 PECOS PAC ID: 8820902794 Enrollment ID: O20031114000467 |
| Entity Name | Southwest Ohio Anesthesia Consultants Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588645188 PECOS PAC ID: 6901700640 Enrollment ID: O20031124000399 |
| Entity Name | Northstar Anesthesia Of Ohio Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417276429 PECOS PAC ID: 3173648300 Enrollment ID: O20100927000005 |
| Entity Name | Legacy Anesthesia Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760741292 PECOS PAC ID: 3274777180 Enrollment ID: O20130916000401 |
| Entity Name | Dayton Anesthesia & Pain Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629401898 PECOS PAC ID: 8022245372 Enrollment ID: O20131212001655 |
| Mailing Address | Practice Location Address |
|---|---|
| Shawn Michael Kotlyn, CRNA 1414 Honeygold Ln, Broadview Heights, OH 44147-3630 Ph: (440) 570-4022 | Shawn Michael Kotlyn, CRNA 1414 Honeygold Ln, Broadview Heights, OH 44147-3630 Ph: (440) 570-4022 |
Agina M. Kempen, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 340 Countryside Dr, Broadview Heights, OH 44147 Phone: 412-860-1976 | |
Ms. Janice Ann Mcfadden, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 125 Turnberry Xing, Broadview Heights, OH 44147 Phone: 440-666-3883 |