Individual provider Active NPI

Katelyn Kunkle, DPT

  • Physical Therapist
  • Manhasset, NY
National Provider Identifier
1316299845
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
042131 Issued in NY
Practice address
1554 Northern Blvd FL 4
Manhasset, NY 11030-3006
Phone
(516) 627-8470
NPI assigned
Oct 8, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 042131 NY Primary

Addresses

Primary practice location

1554 Northern Blvd FL 4
Manhasset, NY 11030-3006

Mailing address

357 Glen Ave
Sea Cliff, NY 11579-1526
Phone (908) 461-6393

Other practice location 1

70 Glen St
Suite 380
Glen Cove, NY 11542-2855
Phone (516) 945-9108

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
042131NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1316299845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 GLEN AVE",
            "city": "SEA CLIFF",
            "state": "NY",
            "postal_code": "115791526",
            "telephone_number": "908-461-6393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1554 NORTHERN BLVD FL 4",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303006",
            "telephone_number": "516-627-8470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Glen St",
            "address_2": "Suite 380",
            "address_purpose": "LOCATION",
            "city": "Glen Cove",
            "state": "NY",
            "postal_code": "115422855",
            "country_code": "US",
            "telephone_number": "516-945-9108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUNKLE",
        "first_name": "KATELYN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "042131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.