Individual provider Active NPI

Irene Katsamanis, PSY.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1497938377
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
017424 Issued in NY
Practice address
307 E 105TH St
1S
New York, NY 10029-5015
Phone
(718) 309-3945
NPI assigned
Dec 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 017424 NY Primary

Addresses

Primary practice location

307 E 105TH St
1S
New York, NY 10029-5015

Mailing address

13301 Booth Memorial Ave
8A
Flushing, NY 11355-5135
Phone (718) 309-3945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197504000000",
    "number": "1497938377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13301 BOOTH MEMORIAL AVE",
            "address_2": "8A",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555135",
            "telephone_number": "718-309-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 E 105TH ST",
            "address_2": "1S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100295015",
            "telephone_number": "718-309-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATSAMANIS",
        "first_name": "IRENE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2007-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "017424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.