DR. MICHAEL ROY KOTELES JR. (NPI# 1093799959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093799959 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL ROY KOTELES JR. |
| Credential | M.D. |
| Practice Address |
101 Bodin Cir Travis Afb CA 94535-1809 |
| Practice Telephone | 7074237963 |
| Mailing Telephone | 7074237963 |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2013-04-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 4302089244 | MI | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | MD00044508 | WA | Allopathic & Osteopathic Physicians |
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
C55542 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
101 BODIN CIR |
| City | TRAVIS AFB |
| State | CA |
| Zip Code | 94535-1809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801893276 | Charles A Tujo | Radiology | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2005-06-30 |
| 1538769351 | Chelsey Violet Pelkey | Military Health Care Provider | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-10-30 |
| 1538768114 | Jordan Rose | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-10-23 |
| 1821606591 | Madelyn Hale | Military Health Care Provider | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-07-20 |
| 1932727856 | Julie Thein | Audiologist | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-07-07 |
| 1063039501 | Shae Daniel Bryant | Dentist | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-07-01 |
| 1598381089 | Aaron J Surbaugh | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-06-19 |
| 1194348466 | Amanda Vance | Registered Nurse | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-05-21 |
| 1427681196 | Bradley Burkey | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-02-20 |
| 1821629288 | Gloria Calvillo | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-02-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487711 | Sheila C Flood | Student in an Organized Health Care Education/Training Program | 101 Biden Circle, Fairfield, CA 94535 | 2020-04-28 |
| 1568081255 | Miguel Julian Moreno | Student in an Organized Health Care Education/Training Program | 690 Airmen Drive, Travis Afb, CA 94535 | 2020-04-13 |
| 1174096101 | Zlatoslava Karga | Nurse Practitioner | 60mdg / Sgow, 101 Bodin Circle, Travis Afb, CA 94535 | 2019-01-02 |
| 1437648292 | Luke C Vera | Dentist | David Grant Medical Center 101 Bodin Circle, Travis Air Force Base, CA 94535 | 2018-05-08 |
| 1588163430 | Sanaz Ziad | Pharmacist | 60mdg/mdts, 101 Bodin Circle, Travis Afb, CA 94535 | 2018-02-06 |
| 1194265686 | Geoffrey Johnston | Dentist | 60 Mdg/sgdd, 101 Bodin Circle, Travis Afb, CA 94535 | 2017-03-02 |
| 1336693407 | Hannah Isla Nordwall | Social Worker | 60 Mdg/mdos 101 Bodin Cir, Travis Afb, CA 94535 | 2016-08-06 |
| 1184177149 | Taylor Murrie-robinson | Social Worker | 60mdg / Sgow Mental Health Clinic, 101 Bodin Circle, Travis Afb, CA 94535 | 2016-07-26 |
| 1952759607 | Eric Kincaid-sharp | General Practice | 60 Mdg/amds, 101 Bodin Cir, Travis Afb, CA 94535 | 2016-06-02 |
| 1023472040 | Genieve Marie Martinez-hernandez | Internal Medicine | 60 Mdg/sgomi, 101 Bodin Circle, Fairfield, CA 94535 | 2016-04-06 |
| Find all providers in zip 94535 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376531665 | John Paul Mckenna Jr. | Internal Medicine | 101 Bodin Cir, 60 Mdg/sgomm, Travis Afb, CA 94535-1809 | 2005-10-11 |
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| 1366061863 | Karen L. Herbst, Md, PC | Internal Medicine | 12381 Wilshire Blvd Ste 202, Los Angeles, CA 90025-1063 | 2020-04-14 |
| 1619502572 | Pacific Endocrinology | Internal Medicine | 1855 1st Ave Ste 200b, San Diego, CA 92101-2685 | 2020-03-11 |
| 1659910743 | Robert Alan Rubin | Internal Medicine | 403 Paseo Miramar, Redondo Beach, CA 90277-6288 | 2020-01-06 |
| 1336790914 | Northeast Community Clinic | Internal Medicine | 4455 W 117th St Ste 502, Hawthorne, CA 90250-2261 | 2019-09-24 |
| 1124585393 | Steady Health Inc | Internal Medicine | 100 Bush St Ste 1600, San Francisco, CA 94104-3918 | 2019-02-25 |
| 1780140673 | Jennifer Anne Nuovo | Internal Medicine | 8880 Cal Center Dr Ste 300, Sacramento, CA 95826-3228 | 2019-02-15 |
| 1407324379 | Chrysalis Health of California | Internal Medicine | 4592 Camino Del Mirasol, Santa Barbara, CA 93110-1003 | 2018-11-08 |
| 1881172864 | Todd Lorenz | Internal Medicine | 5 Robert Rd, Orinda, CA 94563-3215 | 2018-08-01 |
| Find all providers with the same taxonomy | ||||
| City | TRAVIS AFB |
| Zip Code | 94535 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.