Individual provider Active NPI

William H Kalafatic, MD

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1578630034
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
126527 Issued in NY
Practice address
1049 E 163 St
Bronx, NY 10459
Phone
(718) 589-6210
Fax
(718) 589-7400
NPI assigned
Nov 29, 2006
Last updated
Apr 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 126527 NY Primary

Addresses

Primary practice location

1049 E 163 St
Bronx, NY 10459

Mailing address

1049 E 163Rd St
Bronx, NY 10459-4510
Phone (718) 589-6210

Other identifiers 1

IdentifierTypeStateIssuer
236026MedicaidNY

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110408000305 NY Practitioner - Internal Medicine 0941484315 Practice locations: Bronx, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
126527NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1578630034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 E 163RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104594510",
            "telephone_number": "718-589-6210",
            "fax_number": "718-589-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 E 163 ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10459",
            "telephone_number": "718-589-6210",
            "fax_number": "718-589-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALAFATIC",
        "first_name": "WILLIAM",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "126527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "236026",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.