Kerry L Katlic, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

146679 Issued in NY

Practice address

2067 Fairport Nine Mile PT Rd
Penfield, NY 14526-1753

Phone

(585) 922-0460

Fax

(585) 922-0470

NPI assigned

Mar 10, 2006

Last updated

May 12, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Rochester General Hospital

  dba Rochester General Medical Groups

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1356412712

  Pediatrics

  Medicare reassignment NPD
• Western New York Medical Practice P.C.

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1063790608

  Pediatrics

  Medicare reassignment NPD
• Rochester General Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1255360517
  NPD
• Rochester General Hospital

  • Multi-Specialty Clinic/Center
  • Rochester, NY
  • NPI 1861568594
  NPD

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1306814660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2067 FAIRPORT NINE MILE PT RD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261753",
            "telephone_number": "585-922-0460",
            "fax_number": "585-922-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2067 FAIRPORT NINE MILE PT RD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261753",
            "telephone_number": "585-922-0460",
            "fax_number": "585-922-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATLIC",
        "first_name": "KERRY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "146679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00762047",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Rose Kahler, LMHC-P
• Elliot Ira Kaplan, M.D.,PHD.
• Kapson Senior Quarters Corp. (Penfield)
• Amanda Karlsson-Harter, PT
• Karyn Dietz Therapy Inc
• Tami R Keiser
• Deborah Grace Kelleher-Jordan, CCC-SLP
• Allison Kem
• Richard Gordon Kennedy, M.D.
• Harpreet Kaur Khera, RN, PMHNP

• Pediatrics Physician in Penfield, NY
• Providers in Penfield, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.