AMY D KOTANSKY (MS, RD, CDCES, LD) – Registered Dietitian, NPI 1962413682
Registered Dietitian
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for AMY D KOTANSKY (MS, RD, CDCES, LD)
4321 APPLE CROSS DR
INDIANAPOLIS, IN 462543629
Phone: (317) 413-5932
Fax: (317) 865-5321
Type: Mailing
PO BOX 664056
INDIANAPOLIS, IN 462664056
Phone: (317) 265-5904
Fax: (317) 865-5321
Type: Mailing
PO BOX 781076
DETROIT, MI 482783629
Phone: (317) 528-4800
Fax: (317) 865-1479
Type: Mailing
5230 E STOP 11 RD STE 150
INDIANAPOLIS, IN 462376399
Phone: (317) 865-5904
Fax: (317) 865-5321
Type: Location
5230, East Stop 11 Road, Indianapolis, Indiana, 46237, United States
SUITE 150
INDIANAPOLIS, IN 462376398
Phone: (317) 865-5904
Fax: (317) 865-5321
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2009-01-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20090108000224 | I | Registered Dietitian Or Nutrition Professional | IN | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46254)
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