Active NPI
Stewart Kalatsky
- Specialist
- Lawrence, NY
National Provider Identifier
1518030782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- N004245
- Practice address
- 56 Lawrence Ave
Lawrence, NY 11559-1436 - Phone
- (516) 239-0280
- NPI assigned
- Nov 16, 2006
- Last updated
- Dec 22, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 6451500001 | NY | |
| Specialist | 174400000X | N004245 | NY | Primary |
Addresses
Primary practice location
56 Lawrence Ave
Lawrence, NY 11559-1436
Mailing address
56 Lawrence Ave
Lawrence, NY 11559-1436
Phone (516) 239-0280
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01031227 | Medicaid | NY |
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: No
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100902000559 | NY | Practitioner - Podiatry | 9638293251 | Practice locations: Highland, NY; Yonkers, NY; Spring Valley, NY; Lawrence, NY; Forest Hills, NY; Far Rockaway, NY; Brooklyn, NY; Bronx, NY |
| O20101105001040 | NY | DME Supplier - Physician - General Practice | 6103011929 | Practice locations: Lawrence, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N004245 | NY | MD | Specialist |
| 6451500001 | NY | MD | Durable Medical Equipment & Medical Supplies |
| 004245 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292976000000",
"number": "1518030782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 LAWRENCE AVE",
"city": "LAWRENCE",
"state": "NY",
"postal_code": "115591436",
"telephone_number": "516-239-0280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56 LAWRENCE AVE",
"city": "LAWRENCE",
"state": "NY",
"postal_code": "115591436",
"telephone_number": "516-239-0280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALATSKY",
"first_name": "STEWART",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2010-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NY",
"license": "6451500001",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "N004245",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01031227",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lawrence, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.