Organization Active NPI

Katy Med Supply Inc

  • Durable Medical Equipment & Medical Supplies
  • Staten Island, NY
National Provider Identifier
1184552275
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
KATY MED SUPPLY INC
Practice address
114 Willowbrook Rd # 1B
Staten Island, NY 10302-2405
Phone
(347) 374-2560
NPI assigned
May 11, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Authorized official

Name
Viktor Iasenovyi
Title
Owner
Phone
(347) 374-2560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

114 Willowbrook Rd # 1B
Staten Island, NY 10302-2405

Mailing address

114 Willowbrook Rd # 1B
Staten Island, NY 10302-2405

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1778457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778457600000",
    "number": "1184552275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 WILLOWBROOK RD # 1B",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103022405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WILLOWBROOK RD # 1B",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103022405",
            "telephone_number": "347-374-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATY MED SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-11",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A",
        "authorized_official_last_name": "IASENOVYI",
        "authorized_official_first_name": "VIKTOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-374-2560"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; 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.