Individual provider Active NPI

Patty Lo Kallan, LMT

  • Massage Therapist
  • New York, NY
National Provider Identifier
1538753223
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
022906-1 Issued in NY
Practice address
512 7TH Ave FL 14
New York, NY 10018-4603
Phone
(212) 768-7979
NPI assigned
Feb 24, 2021
Last updated
Feb 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 022906-1 NY Primary

Addresses

Primary practice location

512 7TH Ave FL 14
New York, NY 10018-4603

Mailing address

9805 63Rd Rd Apt 12N
Rego Park, NY 11374-1723
Phone (917) 340-1334

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
022906-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nyc Chiropractic PastSince Mar 4, 2021 Accepting new patients
7TH Avenue Physical Medicine & Rehabilitation PastSince Mar 4, 2021 Accepting new patients

Organizations & group practices 2

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": "1614124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1538753223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9805 63RD RD APT 12N",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741723",
            "telephone_number": "917-340-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 7TH AVE FL 14",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100184603",
            "telephone_number": "212-768-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLAN",
        "first_name": "PATTY",
        "middle_name": "LO",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-24",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "022906-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.