Individual provider Active NPI

Stewart Kalatsky

  • Specialist
  • Lawrence, NY
National Provider Identifier
1518030782
Registry record updated Dec 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
N004245 Issued in NY
Practice address
56 Lawrence Ave
Lawrence, NY 11559-1436
Phone
(516) 239-0280
NPI assigned
Nov 16, 2006
Last updated
Dec 22, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
01031227MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
N004245NYMDSpecialist
6451500001NYMDDurable Medical Equipment & Medical Supplies
004245NYMDPhysician 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

Verify at the official NPI Registry.