Individual provider Active NPI

Katrina Tulla, DO

  • Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1235667676
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
321355 Issued in NY
Practice address
9413 Flatlands Ave Ste 201
Brooklyn, NY 11236-3726
Phone
(718) 240-8846
NPI assigned
May 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X H0094172 MD
Student in an Organized Health Care Education/Training Program 390200000X NY
Surgery Physician 208600000X 321355 NY Primary

Addresses

Primary practice location

9413 Flatlands Ave Ste 201
Brooklyn, NY 11236-3726

Mailing address

1 Brookdale PLZ Ste 204
Brooklyn, NY 11212-3139
Phone (718) 240-8043

Other practice location 1

374 Stockholm St
Brooklyn, NY 11237-4006
Phone (718) 963-7272

Other practice location 2

2000 Medical Pkwy
Annapolis, MD 21401-3742
Phone (443) 481-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220613001116 MD Practitioner - General Surgery 9436537990 Reassigns benefits to 1 organization
I20230919003154 NY Practitioner - General Surgery 9436537990 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Nova Southeastern College of Osteo Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interfaith Professional Physician Services PCGroup PAC ID 9931378171, 383 clinicians

Practice addresses (Care Compare)

1 Brookdale PLZ
Brooklyn, NY 11212-3198

1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone (718) 613-4000

Hospital & facility affiliations

  • Brookdale Hospital Medical Center Hospital, Brooklyn, NY, CCN 330233

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
H0094172MDMDSurgery Physician
321355NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Brookdale Hospital Medical Center CurrentSince Aug 1, 2023 Accepting new patients
Luminis Health Medical Group, LLC Surgery CurrentSince Jul 28, 2022 Accepting new patients
Interfaith Professional Physician Services, P.C. Surgery CurrentSince Aug 1, 2023 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Jul 28, 2022 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Brookdale Hospital Medical Center CurrentSince Aug 1, 2023 Accepting new patients
Interfaith Emergency Medicine, P.C. Current Accepting new patients
Luminis Health Medical Group, LLC Past Accepting new patients
The Brookdale Hospital Medical Center Past Accepting new patients

Locations

2000 Medical Pkwy
Ste 600
Annapolis, MD 21401
Phone (443) 481-6699

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

2000 Medical Pkwy
Ste 510
Annapolis, MD 21401
Phone (443) 481-4600

1630 Main St
Ste 213
Chester, MD 21619
Phone (443) 481-5300

2000 Medical Pkwy
Cpe St Claire, MD 21401
Phone (443) 481-3400

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

1 Brookdale Plz
Ste 204
Brooklyn, NY 11212

101 Pennsylvania Ave
Fl 7
Brooklyn, NY 11207
Phone (347) 789-9297

9413 Flatlands Ave
Ste 201W
Brooklyn, NY 11236
Phone (310) 867-3504

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

9413 Flatlands Ave
Ste 201
Brooklyn, NY 11236
Phone (718) 240-8446

4045 78th St
Elmhurst, NY 11373
Phone (718) 397-9058

Networks

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

Interoperability endpoints

  • Direct secure messaging: ktulla142043@direct.aahs.org

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 and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1235667676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLZ STE 204",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123139",
            "telephone_number": "718-240-8043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9413 FLATLANDS AVE STE 201",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363726",
            "telephone_number": "718-240-8846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "374 Stockholm St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112374006",
            "country_code": "US",
            "telephone_number": "718-963-7272",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Medical Pkwy",
            "address_purpose": "LOCATION",
            "city": "Annapolis",
            "state": "MD",
            "postal_code": "214013742",
            "country_code": "US",
            "telephone_number": "443-481-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TULLA",
        "first_name": "KATRINA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-30",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "H0094172",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "321355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.