Active NPI
Kathleen Marie Lagreca, RN
- Registered Nurse
- Hampton Bays, NY
National Provider Identifier
1073789236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 282164
- Practice address
- 4 Oakwood Rd
Hampton Bays, NY 11946-3611 - Phone
- (631) 728-6308
- NPI assigned
- May 7, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 282164 | NY | Primary |
Addresses
Primary practice location
4 Oakwood Rd
Hampton Bays, NY 11946-3611
Mailing address
4 Oakwood Rd
Hampton Bays, NY 11946-3611
Phone (631) 728-6308
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 282164 | Other | NY | RN LICENSE |
| 02745393 | Other | NY | MEDICAID PROVIDER |
Other names 1
- Mrs. Kathleen Marie Blumenthal
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 282164 | NY | MD | Nuclear Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210118400000",
"number": "1073789236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 OAKWOOD RD",
"city": "HAMPTON BAYS",
"state": "NY",
"postal_code": "119463611",
"telephone_number": "631-728-6308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 OAKWOOD RD",
"city": "HAMPTON BAYS",
"state": "NY",
"postal_code": "119463611",
"telephone_number": "631-728-6308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAGRECA",
"first_name": "KATHLEEN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-07",
"last_updated": "2008-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "282164",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE",
"identifier": "282164",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID PROVIDER",
"identifier": "02745393",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KATHLEEN",
"last_name": "BLUMENTHAL",
"middle_name": "MARIE",
"prefix": "MRS.",
"credential": "RN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Hampton Bays, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.