Dr Kotaro Takeda, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in New Haven, Connecticut. His current practice location is
20 York St, New Haven, Connecticut. You can reach out to his office (for appointments etc.) via phone at
(203) 688-4242.
Dr Kotaro Takeda is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1811494313.
Physician's Profile
| Full Name | Dr Kotaro Takeda |
|---|
| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 20 York St, New Haven, Connecticut |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1811494313
- Provider Enumeration Date: 04/11/2018
- Last Update Date: 04/05/2024
Medicare PECOS Information:
- PECOS PAC ID: 5698021541
- Enrollment ID: I20240523001129
Medical Identifiers
Medical identifiers for Dr Kotaro Takeda such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1811494313 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207ZP0101X | Pathology - Anatomic Pathology | 328985 (New York) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (North Carolina) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kotaro Takeda is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Kotaro Takeda, MD
20 York St,
New Haven, CT 06510-3220
Ph: (203) 688-4242 | Dr Kotaro Takeda, MD
20 York St,
New Haven, CT 06510-3220
Ph: (203) 688-4242 |
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