Individual provider Active NPI

Kathryn Portera

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1780162180
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
030654-01 Issued in NY
Practice address
44 Court St Ste 1217
Brooklyn, NY 11201-4410
Phone
(347) 970-2188
NPI assigned
Jul 30, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X CA
Speech-Language Pathologist 235Z00000X 12675 CA
Speech-Language Pathologist 235Z00000X 030654-01 NY Primary

Addresses

Primary practice location

44 Court St Ste 1217
Brooklyn, NY 11201-4410

Mailing address

136 E 76TH St
New York, NY 10021-2825
Phone (631) 603-4513

Other practice location 1

16500 Ventura Blvd Ste 414
Encino, CA 91436
Phone (631) 603-4513

Other practice location 2

7000 Austin St Ste 200
Forest Hills, NY 11375-4739
Phone (718) 762-7633

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
030654-01NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1780162180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 E 76TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212825",
            "telephone_number": "631-603-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 COURT ST STE 1217",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014410",
            "telephone_number": "347-970-2188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16500 Ventura Blvd Ste 414",
            "address_purpose": "LOCATION",
            "city": "Encino",
            "state": "CA",
            "postal_code": "91436",
            "country_code": "US",
            "telephone_number": "631-603-4513",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7000 Austin St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113754739",
            "country_code": "US",
            "telephone_number": "718-762-7633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTERA",
        "first_name": "KATHRYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "12675",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "030654-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.