Individual provider Active NPI

Ekaterina Kimatova

  • School Registered Nurse
  • Flushing, NY
National Provider Identifier
1013799634
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
639241 Issued in NY
Practice address
15323 76TH Rd
Flushing, NY 11367-3122
Phone
(347) 761-1885
NPI assigned
Oct 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 639241 NY Primary

Addresses

Primary practice location

15323 76TH Rd
Flushing, NY 11367-3122

Mailing address

15323 76TH Rd
Flushing, NY 11367-3122
Phone (347) 761-1885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
639241NYMDSchool Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1013799634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15323 76TH RD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673122",
            "telephone_number": "347-761-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15323 76TH RD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673122",
            "telephone_number": "347-761-1885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMATOVA",
        "first_name": "EKATERINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "639241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.