Individual provider Active NPI

Elena Patchke, PT

  • Specialist
  • Rockville Centre, NY
National Provider Identifier
1447702600
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
6305 Issued in NY
Practice address
130 Lee Ave
Rockville Centre, NY 11570-3018
Phone
(516) 536-2741
Fax
(516) 536-2741
NPI assigned
Nov 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 6305 NY Primary

Addresses

Primary practice location

130 Lee Ave
Rockville Centre, NY 11570-3018

Mailing address

130 Lee Ave
Rockville Centre, NY 11570-3018
Phone (516) 536-2741

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6305NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1447702600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 LEE AVE",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703018",
            "telephone_number": "516-536-2741",
            "fax_number": "516-536-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 LEE AVE",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703018",
            "telephone_number": "516-536-2741",
            "fax_number": "516-536-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATCHKE",
        "first_name": "ELENA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-03",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "6305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.