Individual provider Active NPI

Katrina Impreso

  • Physical Medicine & Rehabilitation Physician
  • Forest Hills, NY
National Provider Identifier
1225613912
Registry record updated Mar 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
043971 Issued in NY
Practice address
6860 Austin St Ste 307
Forest Hills, NY 11375-4223
Phone
(718) 880-1716
NPI assigned
Mar 14, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 26800 MD
Physical Medicine & Rehabilitation Physician 208100000X 043971 NY Primary

Addresses

Primary practice location

6860 Austin St Ste 307
Forest Hills, NY 11375-4223

Mailing address

4150 78TH St Apt 308
Elmhurst, NY 11373-1903

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220602001132 NY Practitioner - Physical Therapist in Private Practice 4880072933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8002 Kew Gardens Rd
FL 4
Kew Gardens, NY 11415-3604
Phone (718) 263-7500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
043971NYMDPharmacist
26800MDMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC CurrentSince Jun 1, 2022 Accepting new patients
Professional Occupational & Physical Therapy, PLLC CurrentSince Jun 1, 2022 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Current Accepting new patients

Locations

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

8002 Kew Gardens Rd
Fl 4
Kew Gardens, NY 11415
Phone (718) 263-7500

576 Broadhollow Rd
Melville, NY 11747

22005 Hillside Ave
Queens Village, NY 11427
Phone (718) 400-8330

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1615680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615680000000",
    "number": "1225613912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 78TH ST APT 308",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6860 AUSTIN ST STE 307",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754223",
            "telephone_number": "718-880-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMPRESO",
        "first_name": "KATRINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-14",
        "last_updated": "2021-03-14",
        "certification_date": "2021-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "26800",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "043971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2021; 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.