Individual provider Active NPI

Kathryn G Taras, ANP

  • Nurse Practitioner
  • Seneca Falls, NY
National Provider Identifier
1073509162
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F3403691 Issued in NY
Practice address
1991 Balsley Rd
Seneca Falls, NY 13148-9714
Phone
(315) 539-0237
Fax
(315) 539-0940
NPI assigned
Sep 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F3403691 NY Primary

Addresses

Primary practice location

1991 Balsley Rd
Seneca Falls, NY 13148-9714

Mailing address

1991 Balsley Rd
Seneca Falls, NY 13148-9714
Phone (315) 539-0237

Other identifiers 1

IdentifierTypeStateIssuer
01857758MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071214000604 NY Practitioner - Nurse Practitioner 6002906963 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F3403691NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NV Pacs 2 LLC CurrentSince Jul 1, 2021 Accepting new patients
New York General Medical Services PC CurrentSince Feb 27, 2019 Accepting new patients

Locations

3530 Wayne Ave
Bronx, NY 10467
Phone (718) 655-1700

17850 Linden Blvd
Rochdale Village, NY 11434
Phone (718) 990-0300

101 Elm St
Sayville, NY 11782
Phone (631) 244-2400

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1073509162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 BALSLEY RD",
            "city": "SENECA FALLS",
            "state": "NY",
            "postal_code": "131489714",
            "telephone_number": "315-539-0237",
            "fax_number": "315-539-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 BALSLEY RD",
            "city": "SENECA FALLS",
            "state": "NY",
            "postal_code": "131489714",
            "telephone_number": "315-539-0237",
            "fax_number": "315-539-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARAS",
        "first_name": "KATHRYN",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-23",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F3403691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01857758",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca Falls, NY

Sources for this page

Verify at the official NPI Registry.