Individual provider Active NPI

Irina Katkovskaya, OD

  • Optometrist
  • Bronx, NY
National Provider Identifier
1699856021
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
006937 Issued in NY
Practice address
MMC - Dept. of Ophthalmology
3400 Bainbridge Avenue
Bronx, NY 10467
Phone
(718) 920-2020
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 006937 NY Primary

Addresses

Primary practice location

MMC - Dept. of Ophthalmology
3400 Bainbridge Avenue
Bronx, NY 10467

Mailing address

2300 Olinville Ave
Apt. 17F
Bronx, NY 10467-7817
Phone (718) 920-2020

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050928000231 NY Practitioner - Optometry 3173558293 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006937NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Aug 16, 2005 Accepting new patients
Montefiore Medical Center CurrentSince Aug 16, 2005 Accepting new patients

Locations

3332 Rochambeau Ave
Bronx, NY 10467
Phone (718) 920-5520

111 E 210th St
Bronx, NY 10467

Interoperability endpoints

  • Direct secure messaging: ikatkovskaya966426@nychhc.direct-ci.com

Organizations & group practices 2

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699856021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 OLINVILLE AVE",
            "address_2": "APT. 17F",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104677817",
            "telephone_number": "718-920-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MMC - DEPT. OF OPHTHALMOLOGY",
            "address_2": "3400 BAINBRIDGE AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-920-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATKOVSKAYA",
        "first_name": "IRINA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "006937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.