NPIMap

Individual provider Active NPI

Katrina Jeanne Manos, DPM

  • Foot & Ankle Surgery Podiatrist
  • Rochester, NY
National Provider Identifier
1770710683
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
006474 Issued in NY
Practice address
2236 Ridge Rd W.
Rochester, NY 14626-2804
Phone
(585) 225-2290
Fax
(585) 225-1367
NPI assigned
Jun 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 1235 MA
Foot & Ankle Surgery Podiatrist 213ES0103X 006474 NY Primary

Addresses

Primary practice location

2236 Ridge Rd W.
Rochester, NY 14626-2804

Mailing address

2236 Ridge Rd. W
Rochester, NY 14626-2804
Phone (585) 225-2290

Other names 1

  • Miss Katrina Jeanne Hallahn Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120713000566 NY Practitioner - Podiatry 5991960171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westside Podiatry Group LLCGroup PAC ID 3971543554, 3 clinicians

Practice addresses (Care Compare)

103 Canal Landing Blvd
Rochester, NY 14626-5108
Phone (585) 225-2290

2236 W Ridge Rd
Rochester, NY 14626-2804

919 Westfall Rd BLDG C
Suite 130
Rochester, NY 14618-2638
Phone (585) 506-9790

Hospital & facility affiliations

  • Unity Hospital Hospital, Rochester, NY, CCN 330226

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue67
Removal of skin lesions36
Removal of nail tissue892
Removal or shaving of skin growth381
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1235MAMDPsychologist
006474NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Podiatry Group LLC Foot & Ankle Surgery CurrentSince Jul 1, 2012 Accepting new patients
Westside Podiatry Group LLC Foot & Ankle Surgery CurrentSince Jul 1, 2012 Accepting new patients

Locations

507 Beahan Rd
Rochester, NY 14624
Phone (585) 247-2170

2236 W Ridge Rd
Rochester, NY 14626
Phone (585) 225-2290

Interoperability endpoints

  • Direct secure messaging: khallahan@westsidepodiatrygroup.medentdirect.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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1770710683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2236 RIDGE RD. W",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146262804",
            "telephone_number": "585-225-2290",
            "fax_number": "585-225-1367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2236 RIDGE RD W.",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146262804",
            "telephone_number": "585-225-2290",
            "fax_number": "585-225-1367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANOS",
        "first_name": "KATRINA",
        "middle_name": "JEANNE",
        "name_prefix": "Mrs.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MA",
            "license": "1235",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "006474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATRINA",
            "last_name": "HALLAHN",
            "middle_name": "JEANNE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.