Individual provider Active NPI

Katarina Tibensky

  • Pharmacist
  • Sayre, PA
National Provider Identifier
1285352757
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP457038 Issued in PA
Practice address
430 N Keystone Ave
Sayre, PA 18840-1831
Phone
(570) 888-7763
NPI assigned
Aug 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP457038 PA Primary

Addresses

Primary practice location

430 N Keystone Ave
Sayre, PA 18840-1831

Mailing address

1224 Edward St
Vestal, NY 13850-1706
Phone (607) 621-9167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RP457038PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania CVS Pharmacy, L.L.C. PastSince Aug 28, 2022 Accepting new patients

Organizations & group practices 1

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": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1285352757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 EDWARD ST",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501706",
            "telephone_number": "607-621-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 N KEYSTONE AVE",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401831",
            "telephone_number": "570-888-7763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBENSKY",
        "first_name": "KATARINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP457038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sayre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.