Individual provider Active NPI

Erica Kotkiewicz, PT, DPT

  • Physical Therapist
  • East Meadow, NY
National Provider Identifier
1659703171
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
030339-1 Issued in NY
Practice address
780 Cynthia Dr
East Meadow, NY 11554-4920
Phone
(516) 850-9031
NPI assigned
Aug 7, 2013
Last updated
Jan 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 39723 CA
Physical Therapist 225100000X 030339-1 NY Primary

Addresses

Primary practice location

780 Cynthia Dr
East Meadow, NY 11554-4920

Mailing address

780 Cynthia Dr
East Meadow, NY 11554-4920
Phone (516) 850-9031

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
39723CAMDDentist
030339NYMDPharmacist
030339-1NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1659703171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 CYNTHIA DR",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115544920",
            "telephone_number": "516-850-9031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 CYNTHIA DR",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115544920",
            "telephone_number": "516-850-9031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTKIEWICZ",
        "first_name": "ERICA",
        "name_prefix": "Ms.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-07",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39723",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "030339-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.