Active NPI
Kellyann Niotis, M.D.
- Neurology Physician
- New York, NY
National Provider Identifier
1124472071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 302456
- Practice address
- 428 E 72ND St Ofc 500
New York, NY 10021-0600 - Phone
- (212) 746-0226
- NPI assigned
- Apr 18, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 302456 | NY | Primary |
Addresses
Primary practice location
428 E 72ND St Ofc 500
New York, NY 10021-0600
Mailing address
428 E 72ND St Ofc 500
New York, NY 10021-0600
Other practice location 1
28 Regency Way
Manalapan, NJ 07726-8674
Phone (908) 930-1505
Other practice location 2
428 E 72nd St Ofc 500
New York, NY 10021-0600
Phone (212) 746-0226
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 3, 2025 through Jan 3, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- kellyann.niotis@836821628223492.direct.elationemr.com
- ken9029@direct.nyp.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627862400000",
"number": "1124472071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "428 E 72ND ST OFC 500",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100210600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "428 E 72ND ST OFC 500",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100210600",
"telephone_number": "212-746-0226"
}
],
"practiceLocations": [
{
"address_1": "28 Regency Way",
"address_purpose": "LOCATION",
"city": "Manalapan",
"state": "NJ",
"postal_code": "077268674",
"country_code": "US",
"telephone_number": "908-930-1505",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "428 E 72nd St Ofc 500",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100210600",
"country_code": "US",
"telephone_number": "212-746-0226",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NIOTIS",
"first_name": "KELLYANN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-18",
"last_updated": "2021-08-02",
"certification_date": "2021-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NY",
"license": "302456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.