Individual provider Active NPI

Katina Tsahalis, PA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1255736922
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
018135 Issued in NY
Practice address
1722 W 9TH St
Brooklyn, NY 11223-1239
Phone
(860) 510-1675
NPI assigned
Oct 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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 018135 NY Primary

Addresses

Primary practice location

1722 W 9TH St
Brooklyn, NY 11223-1239

Mailing address

1722 W 9TH St
Brooklyn, NY 11223-1239

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180517000343 NY Practitioner - Physician Assistant 5496010696 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercy College, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wonder Years Psychiatric Services PLLCGroup PAC ID 9931584612, 2 clinicians

Practice addresses (Care Compare)

26 Court St
Suite 816
Brooklyn, NY 11242-1108
Phone (347) 987-4233

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wonder Years Psychiatric Services of New Jersey PC PastSince Apr 23, 2023 Accepting new patients

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": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1255736922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 W 9TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112231239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 W 9TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112231239",
            "telephone_number": "860-510-1675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSAHALIS",
        "first_name": "KATINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.