Individual provider Active NPI

Cathleen Mary Kneidl, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Purchase, NY
National Provider Identifier
1487703526
Registry record updated Mar 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
005002-1 Issued in NY
Practice address
2975 Westchester Ave
Purchase, NY 10577-2518
Phone
(914) 328-3700
NPI assigned
Jan 9, 2007
Last updated
Mar 24, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 005002-1 NY Primary

Addresses

Primary practice location

2975 Westchester Ave
Purchase, NY 10577-2518

Mailing address

19 Bowling LN
Deer Park, NY 11729-6707
Phone (631) 243-3373

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
005002NYMDOccupational Therapy Assistant
005002-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of Greater New York PastSince Nov 19, 2008 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3149/brand/1/csg/22/fhir/r4

Organizations & group practices 1

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300924800000",
    "number": "1487703526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BOWLING LN",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117296707",
            "telephone_number": "631-243-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2975 WESTCHESTER AVE",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "105772518",
            "telephone_number": "914-328-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNEIDL",
        "first_name": "CATHLEEN",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2011-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "005002-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Purchase, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.