JACK PETER KOTLARZ (MD) – Plastic Surgery within the Head & Neck (Otolaryngology) Physician, NPI 1922090646
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
732 OTOLARYNGOLOGY in FL
Provider Addresses for JACK PETER KOTLARZ (MD)
Kotlarz ENT & Facial Plastic Surgery, 6100, North Davis Highway, Heritage Medical Park, Pensacola, Escambia County, Florida, 32504, United States
PENSACOLA, FL 325046950
Phone: (850) 471-2377
Fax: (850) 471-9975
Type: Mailing
3100 E Fletcher Ave
Tampa, FL 336134613
Phone: (813) 971-6000
Fax: (813) 615-7542
Type: Location
1253 N ALPINE RD
ROCKFORD, IL 611072201
Phone: (779) 696-9201
Fax: (815) 397-9667
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 15 Open Payments records for all available years, with a total value of $552.
Total Amount is formed as General ($552) + Research ($0) + Ownership ($0) = $552.
Last reported payment date: 2024-02-01 • Largest payer in this snapshot: GENZYME CORPORATION ($240).
Total Amount
$552
General + Research + Ownership
Payments
15
Total payment records
General Amount
$552
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-01
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GENZYME CORPORATION | $240 |
| Regeneron Healthcare Solutions, Inc. | $142 |
| Optinose US, Inc. | $67 |
| Hikma Pharmaceuticals USA | $47 |
| Stryker Corporation | $21 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-08-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090501000460 | I | Otolaryngology | FL | TBD |
| I20240822002289 | I | Otolaryngology | IL | TBD |
| I20240912002782 | I | Otolaryngology | MO | TBD |
| I20250814001660 | I | Otolaryngology | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 95004 | Test for allergy using allergenic extract | 4,584 | 60 | $0 |
| 95024 | Test for allergy using allergenic extract injected into skin | 1,659 | 57 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1,593 | 917 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1,046 | 604 | $0 |
| 69210 | Removal of impacted ear wax | 763 | 534 | $0 |
Insurance plans in this area (ZIP 32504)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OTOLARYNGOLOGY | FL | 92567 | Eardrum testing using ear probe | 36 | 26 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Cardiac Surgery, Thoracic Surgery | IL | |
| Nurse Practitioner | SC | |
| Nurse Practitioner | FL | |
| Physician Assistant | FL | |
| General Surgery | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Vascular Surgery | FL | |
| Physician Assistant | FL | |
| Nurse Practitioner | FL |
Reviews
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