Individual provider Active NPI

Karen Johanna Carcich, M.S.OTR/L

  • Community Health Worker
  • Flushing, NY
National Provider Identifier
1649413931
Registry record updated Apr 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
006919-1 Issued in NY
Practice address
19708 46TH Ave
Flushing, NY 11358-3515
Phone
(718) 428-3279
Fax
(718) 428-3279
NPI assigned
Apr 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 006919-1 NY Primary

Addresses

Primary practice location

19708 46TH Ave
Flushing, NY 11358-3515

Mailing address

19708 46TH Ave
Flushing, NY 11358-3515
Phone (718) 428-3279

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
006919-1NYMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239840000000",
    "number": "1649413931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19708 46TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583515",
            "telephone_number": "718-428-3279",
            "fax_number": "718-428-3279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19708 46TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583515",
            "telephone_number": "718-428-3279",
            "fax_number": "718-428-3279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARCICH",
        "first_name": "KAREN",
        "middle_name": "JOHANNA",
        "name_prefix": "Mrs.",
        "credential": "M.S.OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-16",
        "last_updated": "2009-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NY",
            "license": "006919-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2009; 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.