Individual provider Active NPI

Caroline Konnoth, BSPT

  • Physical Therapist
  • Flushing, NY
National Provider Identifier
1710954003
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
018592-1 Issued in NY
Practice address
14809 Northern Blvd
Suite 1K
Flushing, NY 11354-4346
Phone
(718) 445-1006
NPI assigned
Mar 5, 2006
Last updated
Mar 27, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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 018592-1 NY Primary

Addresses

Primary practice location

14809 Northern Blvd
Suite 1K
Flushing, NY 11354-4346

Mailing address

8411 252ND St
Bellerose, NY 11426-2118
Phone (718) 347-1469

Other names 1

  • Mrs. Caroline Konnoth Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110908001907 NY Practitioner - Physical Therapist in Private Practice 2567632029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14965 24TH Ave
Whitestone, NY 11357-3654
Phone (718) 359-1006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018592-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Caroline Konnoth Physical Therapy P.C. CurrentSince Jul 29, 2011 Accepting new patients

Locations

14809 Northern Blvd
Ste 1K
Flushing, NY 11354
Phone (347) 506-0325

14965 24th Ave
Whitestone, NY 11357
Phone (718) 445-0500

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, 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": "1141516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1710954003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8411 252ND ST",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114262118",
            "telephone_number": "718-347-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14809 NORTHERN BLVD",
            "address_2": "SUITE 1K",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544346",
            "telephone_number": "718-445-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONNOTH",
        "first_name": "CAROLINE",
        "name_prefix": "Mrs.",
        "credential": "BSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-05",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "018592-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINE",
            "last_name": "KONNOTH",
            "prefix": "MRS.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Mar 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.