NPIMap

Individual provider Active NPI

Tatyana Katsman, D.O.

  • Family Medicine Physician
  • Staten Island, NY
National Provider Identifier
1447259841
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
291980 Issued in NY
Practice address
3974 Amboy Rd Ste 302
Staten Island, NY 10308-2414
Phone
(718) 967-1071
Fax
(888) 908-8284
NPI assigned
Jul 18, 2005
Last updated
Jun 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MB073901 NJ
Family Medicine Physician 207Q00000X 291980 NY Primary

Addresses

Primary practice location

3974 Amboy Rd Ste 302
Staten Island, NY 10308-2414

Mailing address

2690 Kennedy Blvd
Jersey City, NJ 07306-5804
Phone (201) 451-1601

Other identifiers 4

IdentifierTypeStateIssuer
05353219OtherNYMEDICAID
05353219MedicaidNY
291980OtherNYSTATE LICENSE
0079367MedicaidNJ

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
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
291980NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
Hudson Hospital Opco LLC Current Accepting new patients
New Jersey Medical and Health Associates,LLC Single Specialty PastSince Nov 9, 2012 Accepting new patients
Osteopathic Medical Care Center Single Specialty Past Accepting new patients
Steinbaum Levine Associates LLC Single Specialty Past Accepting new patients
Universal Medical Eyecare LLC Single Specialty PastSince Aug 18, 2006 Accepting new patients
Monroe Physical Medicine LLC Single Specialty Past Accepting new patients
Quality Medical Care Single Specialty Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tatyana.katsman@direct.christhospital.md
  • Direct secure messaging: tatyanakatsman@mai.allscriptsdirect.net

Organizations & group practices 9

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1447259841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 KENNEDY BLVD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073065804",
            "telephone_number": "201-451-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3974 AMBOY RD STE 302",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103082414",
            "telephone_number": "718-967-1071",
            "fax_number": "888-908-8284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATSMAN",
        "first_name": "TATYANA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB073901",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "291980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "05353219",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05353219",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "291980",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0079367",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.