Individual provider Active NPI

Katherine Rose Zoda, PT, DPT, ATC

  • Physical Therapist
  • Monroe, NY
National Provider Identifier
1366965451
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
046679 Issued in NY
Practice address
411 State Route 17M
Monroe, NY 10950-4123
Phone
(845) 507-0477
NPI assigned
Jul 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X NY
Basic Emergency Medical Technician 146N00000X 424083 NY
Physical Therapist 225100000X 046679 NY Primary

Addresses

Primary practice location

411 State Route 17M
Monroe, NY 10950-4123

Mailing address

11 Carmen Dr
Nanuet, NY 10954-1902
Phone (845) 304-3191

Other practice location 1

125 Route 340
Sparkill, NY 10976-1041
Phone (845) 398-4057

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230118000308 NY Practitioner - Physical Therapist in Private Practice 4789055450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

490 Route 304
New City, NY 10956-3040
Phone (845) 507-0477

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
424083NYMDBasic Emergency Medical Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Aug 29, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Aug 29, 2022 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

411 State Route 17M
Monroe, NY 10950
Phone (845) 507-0477

490 Route 304
New City, NY 10956
Phone (845) 507-0477

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Organizations & group practices 2

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": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1366965451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CARMEN DR",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109541902",
            "telephone_number": "845-304-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 STATE ROUTE 17M",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109504123",
            "telephone_number": "845-507-0477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Route 340",
            "address_purpose": "LOCATION",
            "city": "Sparkill",
            "state": "NY",
            "postal_code": "109761041",
            "country_code": "US",
            "telephone_number": "845-398-4057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZODA",
        "first_name": "KATHERINE",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-20",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "NY",
            "license": "424083",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "046679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.