Individual ProviderJay S KothariPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansPractice Address3181 SW Sam Jackson Park Rd, Dept Of Psychiatry, C/O Rocio Pozo, Portland, OR 97239-3011(503) 494-8250PECOS EnrollmentThis provider is enrolled in PECOS as JAY KOTHARI.Based on the most recent information from CMS, provider Jay S Kothari is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1750602900Provider TypeIndividualFull NameKothari, Jay STitleDr.CredentialM.D.GenderMaleSole ProprietorNoEnumeration Date6/22/2010Last Updated6/16/2016Contact InformationPractice LocationPractice Address3181 SW Sam Jackson Park Rd, Dept Of Psychiatry, C/O Rocio Pozo, Portland, OR 97239-3011Phone(503) 494-8250Fax(503) 494-6170Mailing LocationMailing Address3181 SW Sam Jackson Park Rd, Dept Of Psychiatry, C/O Rocio Pozo, Portland, OR 97239-3011Phone(503) 494-8250Fax(503) 494-6170Provider TaxonomiesCodeDescriptionLicenseCode2084P0800XPrimaryDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseMD176651OregonCode2084P0804XDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseMD176651Oregon