Individual provider Active NPI

Katharine Anne Pelletier

  • Obstetrics & Gynecology Physician
  • New York, NY
National Provider Identifier
1356848253
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
316372 Issued in NY
Practice address
274 Madison Ave Ste 300
New York, NY 10016-0701
Phone
(212) 201-1217
NPI assigned
Apr 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 316372 NY Primary

Addresses

Primary practice location

274 Madison Ave Ste 300
New York, NY 10016-0701

Mailing address

750 E Adams St
Syracuse, NY 13210-2306

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221128001234 NY Practitioner - Obstetrics/Gynecology 4789920489 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Chen and Morgan OB-GYN Westside PLLCGroup PAC ID 0244206258, 4 clinicians

Practice addresses (Care Compare)

620 Columbus Ave
New York, NY 10024-1458
Phone (212) 580-3866

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
316372NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Chen & Morgan OB-GYN Westside PLLC CurrentSince Aug 1, 2024 Accepting new patients
Yelena Rubinshteyn MD PC PastSince Apr 16, 2023 Accepting new patients

Locations

620 Columbus Ave
Ste 2
New York, NY 10024
Phone (212) 600-9411

620 Columbus Ave
New York, NY 10024
Phone (212) 580-3866

26 Firemens Memorial Dr
Ste 115
Pomona, NY 10970
Phone (212) 229-9590

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": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1356848253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 MADISON AVE STE 300",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160701",
            "telephone_number": "212-201-1217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "KATHARINE",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "316372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.