Individual provider Active NPI

Katherine Wallner, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1619380771
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0376261 Issued in NY
Practice address
99 Wall St Ste 2125
New York, NY 10005-4301
Phone
(516) 946-4214
NPI assigned
Jun 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0376261 NY Primary

Addresses

Primary practice location

99 Wall St Ste 2125
New York, NY 10005-4301

Mailing address

30 Aspen St
Floral Park, NY 11001-3118
Phone (516) 946-4214

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
037626NYMDDentist
0376261NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Rehab Physical Therapy of Ny, P.C. Physical Therapist PastSince May 7, 2018 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1619380771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 ASPEN ST",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110013118",
            "telephone_number": "516-946-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 WALL ST STE 2125",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100054301",
            "telephone_number": "516-946-4214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLNER",
        "first_name": "KATHERINE",
        "name_prefix": "Miss",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-06",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0376261",
            "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 Jan 19, 2022; 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.