Individual provider Active NPI

Jacob Katanov, P.A.

  • Surgical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1396762191
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
007935 Issued in NY
Practice address
540 Atlantic Ave
Brooklyn, NY 11217-1985
Phone
(718) 855-4900
Fax
(718) 802-0631
NPI assigned
Jul 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 007935 NY Primary

Addresses

Primary practice location

540 Atlantic Ave
Brooklyn, NY 11217-1985

Mailing address

2202 Steinway St
Astoria, NY 11105-1836
Phone (718) 423-0808

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
007935NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Katan Orthopedics & Spine Surgery LLC Current Accepting new patients
Surgical PA Services, PC Surgical CurrentSince Feb 9, 2020 Accepting new patients
Premier Surgical Services, P.C. Surgical Past Accepting new patients
MM Medical Service PC Past Accepting new patients
The Parkway Hospital Past Accepting new patients
Miriam Kanter MD PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jkatanov126534@nyumc.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396762191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 STEINWAY ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111051836",
            "telephone_number": "718-423-0808",
            "fax_number": "718-204-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171985",
            "telephone_number": "718-855-4900",
            "fax_number": "718-802-0631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATANOV",
        "first_name": "JACOB",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "007935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.