Individual provider Active NPI

Catherine Rose Kavanagh, M.D.

  • Pediatric Nephrology Physician
  • New York, NY
National Provider Identifier
1447697784
Registry record updated Jun 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
286906 Issued in NY
Practice address
3959 Broadway
CHN 11TH Floor Room 1115
New York, NY 10032
Phone
(212) 305-5824
Fax
(212) 342-0518
NPI assigned
May 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X 286906 NY Primary

Addresses

Primary practice location

3959 Broadway
CHN 11TH Floor Room 1115
New York, NY 10032

Mailing address

3959 Broadway RM 1115
New York, NY 10032-1559
Phone (212) 305-5825

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
I20170411000784 NY Practitioner - Pediatric Medicine 1153607981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Pennsylvania State University College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

161 Fort Washington Ave
New York, NY 10032-3729
Phone (212) 305-8559

3959 Broadway
New York, NY 10032-1559
Phone (212) 305-4636

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Current Accepting new patients
Trustees of Columbia University in the City of New York Past Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients

Locations

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

3959 Broadway
Rm 1115
New York, NY 10032

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

3959 Broadway
New York, NY 10032
Phone (212) 304-7297

3959 Broadway
Fl 11
New York, NY 10032
Phone (212) 305-5824

1111 Westchester Ave
White Plains, NY 10604
Phone (212) 305-1021

Networks

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

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: cak9063@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 4

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.

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": "1369699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591315200000",
    "number": "1447697784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY RM 1115",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "212-305-5825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "address_2": "CHN 11TH FLOOR ROOM 1115",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "212-305-5824",
            "fax_number": "212-342-0518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAGH",
        "first_name": "CATHERINE",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-28",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "NY",
            "license": "286906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.