NPIMap

Individual provider Active NPI

Karleen Koenig, PA

  • Physician Assistant
  • New York, NY
National Provider Identifier
1205884293
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
004574 Issued in NY
Practice address
100 E 77TH St
New York, NY 10021-1850
Phone
(212) 434-2650
Fax
(212) 434-4512
NPI assigned
May 4, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 004574 NY Primary

Addresses

Primary practice location

100 E 77TH St
New York, NY 10021-1850

Mailing address

20 Grand St
FL 3
Warwick, NY 10990-1035
Phone (845) 368-5000

Other identifiers 1

IdentifierTypeStateIssuer
02044200MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051103000195 NY Practitioner - Physician Assistant 1153349642 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
004574NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc. CurrentSince May 15, 2017 Accepting new patients
Metro Emergency Medical Association PLLC Past Accepting new patients
Emergency Medical Metro P C Past Accepting new patients
LH Emergency Medical Services PC Past Accepting new patients
Bon Secours Charity Health System Inc. Past Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 9

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1205884293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GRAND ST",
            "address_2": "FL 3",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109901035",
            "telephone_number": "845-368-5000",
            "fax_number": "845-987-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100211850",
            "telephone_number": "212-434-2650",
            "fax_number": "212-434-4512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "KARLEEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "004574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02044200",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.