Individual provider Active NPI

Katrina Elaina Smith Gretsky, AUD

  • Audiologist
  • Syracuse, NY
National Provider Identifier
1740766336
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
002810-1 Issued in NY
Practice address
1001 James St
Syracuse, NY 13203-2789
Phone
(315) 428-0016
NPI assigned
Jul 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 002810-1 NY Primary

Addresses

Primary practice location

1001 James St
Syracuse, NY 13203-2789

Mailing address

1001 James St
Syracuse, NY 13203-2789

Other names 1

  • Katrina Elaina Smith Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180816003054 NY Practitioner - Qualified Audiologist 1052660503 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002810NYMDMental Health Counselor
002810-1NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Services Company USA, LLC CurrentSince Jul 1, 2018 Accepting new patients
Audiology Services Company USA, LLC Audiologist Current Accepting new patients
Audiology Services Company USA, LLC CurrentSince Jul 1, 2018 Accepting new patients

Locations

2501 Cottontail Ln
Somerset, NJ 08873
Phone (732) 529-7120

5320 W Genesee St
Ste 2
Camillus, NY 13031
Phone (315) 469-5400

240 W Seneca St
Ste 3
Manlius, NY 13104
Phone (315) 682-2025

1001 James St
Syracuse, NY 13203
Phone (315) 428-0016

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1740766336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032789",
            "telephone_number": "315-428-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH GRETSKY",
        "first_name": "KATRINA",
        "middle_name": "ELAINA",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-17",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "002810-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATRINA",
            "last_name": "SMITH",
            "middle_name": "ELAINA",
            "credential": "AUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.