Individual provider Active NPI

Katherine McCauley Graziano, OTR/L, PT, DPT, CLT

  • Physical Therapist
  • Port Jefferson Station, NY
National Provider Identifier
1215318175
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
038879 Issued in NY
Practice address
1010 Route 112
Suite 200
Port Jefferson Station, NY 11776-3387
Phone
(631) 476-4880
NPI assigned
Jun 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 019394 NY
Physical Therapist 225100000X 038879 NY Primary

Addresses

Primary practice location

1010 Route 112
Suite 200
Port Jefferson Station, NY 11776-3387

Mailing address

1010 Route 112
Suite 200
Port Jefferson Station, NY 11776-3387
Phone (631) 476-4880

Other names 1

  • Katherine McCauley Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151013001319 NY Practitioner - Physical Therapist in Private Practice 4183933260 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

180 E Pulaski Rd
Huntington Station, NY 11746-1915
Phone (516) 747-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038879NYMDPharmacist
019394NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Sep 2, 2024 Accepting new patients
New York University CurrentSince Sep 2, 2024 Accepting new patients
Nyumc Radiology Associates Past Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

180 Pulaski Rd
Huntington Station, NY 11746
Phone (631) 425-2121

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

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

Organizations & group practices 3

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": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1215318175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 ROUTE 112",
            "address_2": "SUITE 200",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763387",
            "telephone_number": "631-476-4880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 ROUTE 112",
            "address_2": "SUITE 200",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763387",
            "telephone_number": "631-476-4880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAZIANO",
        "first_name": "KATHERINE",
        "middle_name": "MCCAULEY",
        "credential": "OTR/L, PT, DPT, CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "019394",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "038879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "MCCAULEY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.