Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ivan S Kotchetkov

Individual provider Neurology Physician · NPI 1356634356

Ivan S Kotchetkov is a Neurology in New York, New York. Graduated from Columbia University College of Physicians and Surgeons in 2012, 14 years ago. Practices with Memorial Neurology Group, a 96-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
14
Trained at
Columbia University College of Physicians and Surgeons
Licensed in
NY
In the registry since
2011
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Practice location Address checks out

1275 York Ave
New York, NY 10065-6007
Phone: (212) 639-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X · Licence 293300 (NY)

Record details

NPI number1356634356
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 24, 2011
Last updated in NPPESJune 22, 2020
Certification dateJune 22, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEUROLOGY
Medical schoolCOLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS
Graduated 2012 (14 years in practice)
Group practice Memorial Neurology Group — 96 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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