Individual provider Active NPI

Katherine J Gili, DPT

  • Physical Therapist
  • Glendale, NY
National Provider Identifier
1205442779
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
254492533 Issued in NY
Practice address
7119 80TH St Ste 8210
Glendale, NY 11385-7733
Phone
(718) 554-6610
Fax
(718) 360-4908
NPI assigned
Sep 21, 2020
Last updated
Sep 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 254492533 NY Primary

Addresses

Primary practice location

7119 80TH St Ste 8210
Glendale, NY 11385-7733

Mailing address

7119 80TH St Ste 8210
Glendale, NY 11385-7733
Phone (718) 554-6610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201218002280 NY Practitioner - Physical Therapist in Private Practice 4486066230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promet Physical Therapy PCGroup PAC ID 6901988849, 7 clinicians

Practice addresses (Care Compare)

7119 80TH St
Suite 8210
Glendale, NY 11385-7733
Phone (718) 554-6610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
254492533NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Promet Physical Therapy PC Physical Therapist CurrentSince Nov 16, 2020 Accepting new patients
Promet Physical Therapy, PC Physical Therapist PastSince Sep 27, 2020 Accepting new patients

Locations

7119 80th St
Ste 8210
Glendale, NY 11385
Phone (718) 554-6610

6317 Metropolitan Ave
Middle Village, NY 11379
Phone (718) 456-1016

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1205442779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7119 80TH ST STE 8210",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857733",
            "telephone_number": "718-554-6610",
            "fax_number": "718-360-4908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7119 80TH ST STE 8210",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857733",
            "telephone_number": "718-554-6610",
            "fax_number": "718-360-4908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILI",
        "first_name": "KATHERINE",
        "middle_name": "J",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "254492533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.