Individual provider Active NPI

Katerina Dodelzon, M.D.

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1386887594
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
253854 Issued in NY
Practice address
525 E 68TH St # 141
Newyork-Presbyterian-Weill Cornell Medical Center
New York, NY 10065-4870
Phone
(212) 746-6000
Fax
(646) 962-0122
NPI assigned
Apr 17, 2009
Last updated
Sep 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Diagnostic Radiology Physician 2085R0202X 253854 NY Primary

Addresses

Primary practice location

525 E 68TH St # 141
Newyork-Presbyterian-Weill Cornell Medical Center
New York, NY 10065-4870

Mailing address

575 Lexington Ave RM 540
Newyork-Presbyterian-Weill Cornell Medical College
New York, NY 10022-6145
Phone (212) 746-6000

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address kad9090@direct.nyp.org Direct
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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
I20140731002169 NY Practitioner - Diagnostic Radiology 6406072107 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Iowa, RJ & L Carver College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

520 E 70TH St
New York, NY 10021-9800
Phone (212) 746-6000

525 E 68TH St Box
585 Cornell University Med College
New York, NY 10021-4870
Phone (212) 746-2059

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Physician Services, PC Diagnostic Radiology CurrentSince May 1, 2021 Accepting new patients
Weill Medical College of Cornell CurrentSince Aug 1, 2014 Accepting new patients
Kings Physician Services, PC CurrentSince May 1, 2021 Accepting new patients
Weill Cornell Medical Imaging Diagnostic Radiology CurrentSince Aug 1, 2014 Accepting new patients
Weill Cornell Imaging at New York Presbyterian Diagnostic Radiology CurrentSince Aug 1, 2014 Accepting new patients
Weill Medical College of Cornell Diagnostic Radiology CurrentSince Aug 1, 2014 Accepting new patients

Locations

263 7th Ave
Brooklyn, NY 11215
Phone (718) 246-8510

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

520 E 70th St
New York, NY 10021
Phone (212) 746-0838

525 E 68th St
#141
New York, NY 10065
Phone (212) 746-2059

525 E 68th St
#585
New York, NY 10065
Phone (212) 746-2059

575 Lexington Ave
Rm 540
New York, NY 10022
Phone (646) 962-2543

Networks

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

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1239926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1386887594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 LEXINGTON AVE RM 540",
            "address_2": "NEWYORK-PRESBYTERIAN-WEILL CORNELL MEDICAL COLLEGE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100226145",
            "telephone_number": "212-746-6000",
            "fax_number": "646-962-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST # 141",
            "address_2": "NEWYORK-PRESBYTERIAN-WEILL CORNELL MEDICAL CENTER",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "212-746-6000",
            "fax_number": "646-962-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODELZON",
        "first_name": "KATERINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-17",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "253854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kad9090@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "525 E 68th St # 141",
            "address_2": "NewYork-Presbyterian-Weill Cornell Medical Center",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100654870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "525 E 68th St # 141",
            "address_2": "NewYork-Presbyterian-Weill Cornell Medical Center",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100654870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "525 E 68th St # 141",
            "address_2": "NewYork-Presbyterian-Weill Cornell Medical Center",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100654870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.