Individual provider Active NPI

Katarzyna Klek, MD

  • Pediatrics Physician
  • East Setauket, NY
National Provider Identifier
1639325285
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
261732 Issued in NY
Practice address
4 Technology Dr Ste 250
East Setauket, NY 11733-4085
Phone
(631) 444-5437
NPI assigned
Aug 14, 2008
Last updated
Aug 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 261732 NY Primary

Addresses

Primary practice location

4 Technology Dr Ste 250
East Setauket, NY 11733-4085

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 444-0650

Other identifiers 1

IdentifierTypeStateIssuer
03351851MedicaidNY

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
I20180911002043 NY Practitioner - Pediatric Medicine 8527318682 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Faculty Practice Plan CurrentSince Jul 28, 2018 Accepting new patients
Maimonides Medical Center Current Accepting new patients
MMC Pediatrics Faculty Practice Pediatrics CurrentSince Jul 28, 2018 Accepting new patients

Locations

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

Interoperability endpoints

  • Direct secure messaging: katarzynaklek@mai.allscriptsdirect.net

Organizations & group practices 3

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": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1639325285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989",
            "telephone_number": "631-444-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 TECHNOLOGY DR STE 250",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117334085",
            "telephone_number": "631-444-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEK",
        "first_name": "KATARZYNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-14",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "261732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03351851",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.