Individual provider Active NPI

Katherine Yuri Sumantri

  • Speech-Language Pathologist
  • Long Island City, NY
National Provider Identifier
1174195374
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
3100 47TH Ave Ste 2120D2ND
Long Island City, NY 11101-3013
Phone
(718) 593-4121
NPI assigned
Jul 15, 2021
Last updated
Jul 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

3100 47TH Ave Ste 2120D2ND
Long Island City, NY 11101-3013

Mailing address

275 South St Apt 2D
New York, NY 10002-8097
Phone (646) 275-0163

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

NPI Registry JSON

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1174195374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 SOUTH ST APT 2D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100028097",
            "telephone_number": "646-275-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 47TH AVE STE 2120D2ND",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111013013",
            "telephone_number": "718-593-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMANTRI",
        "first_name": "KATHERINE",
        "middle_name": "YURI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.