Individual provider Active NPI

Mani Katanov, MSED

  • Specialist
  • Floral Park, NY
National Provider Identifier
1386169100
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
24902 Jericho Tpke Ste 207
Floral Park, NY 11001-4000
Phone
(718) 635-2404
NPI assigned
Aug 14, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Specialist 174400000X Primary

Addresses

Primary practice location

24902 Jericho Tpke Ste 207
Floral Park, NY 11001-4000

Mailing address

24902 Jericho Tpke Ste 207
Floral Park, NY 11001-4000
Phone (718) 635-2404

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

Practice roles

OrganizationSpecialtyStatusNew patients
Get Ahead With MK Specialist CurrentSince Dec 15, 2019 Accepting new patients

Locations

24902 Jericho Tpke
Ste 207
Floral Park, NY 11001
Phone (718) 635-2404

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": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1386169100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24902 JERICHO TPKE STE 207",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110014000",
            "telephone_number": "718-635-2404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24902 JERICHO TPKE STE 207",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110014000",
            "telephone_number": "718-635-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATANOV",
        "first_name": "MANI",
        "credential": "MSED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-14",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Floral Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; 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.