NPIMap

Organization Active NPI

Joseph J Katta MD PA

  • Gastroenterology Physician
  • Fort Pierce, FL
National Provider Identifier
1427090224
Registry record updated Jun 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0047323 Issued in FL
Legal business name
JOSEPH J KATTA MD PA
Practice address
1900 Nebraska Ave
Suite 5
Fort Pierce, FL 34950-4837
Phone
(772) 466-7200
Fax
(772) 466-9513
NPI assigned
Jun 13, 2006
Last updated
Jun 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2008

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

Authorized official

Name
Joseph Joseph Katta, MDNPI 1508892563
Title
Direct Owner
Phone
(772) 466-7200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 0047323 FL Primary

Addresses

Primary practice location

1900 Nebraska Ave
Suite 5
Fort Pierce, FL 34950-4837

Mailing address

1900 Nebraska Ave
Suite 5
Fort Pierce, FL 34950-4837
Phone (772) 466-7200

Other identifiers 1

IdentifierTypeStateIssuer
043582100MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080528000559 FL Part B Supplier - Clinic/Group Practice 0244311553 Receives reassigned benefits from 14 practitioners
Practice locations: Port St Lucie, FL; Fort Pierce, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0871808Joseph J Katta MD PA1900 Nebraska Avenue #5, Fort Pierce, FL 34950Certificate of waiverJun 3, 2027

National Provider Directory

National Provider Directory
Tax ID family
Joseph J Katta MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1900 Nebraska Ave
Ste 5
Fort Pierce, FL 34950
Phone (772) 466-7200

1700 SE Hillmoor Dr
Ste 402
Port St Lucie, FL 34952
Phone (772) 335-7883

306 NW Bethany Dr
Port St Lucie, FL 34986
Phone (772) 466-7200

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212537600000",
    "number": "1427090224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 NEBRASKA AVE",
            "address_2": "SUITE 5",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504837",
            "telephone_number": "772-466-7200",
            "fax_number": "772-466-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 NEBRASKA AVE",
            "address_2": "SUITE 5",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504837",
            "telephone_number": "772-466-7200",
            "fax_number": "772-466-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH J KATTA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2008-06-04",
        "status": "A",
        "authorized_official_last_name": "KATTA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "DIRECT OWNER",
        "authorized_official_telephone_number": "772-466-7200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "0047323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043582100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; 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.