Katrina M Agtuca

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

037716-1 Issued in NY

Practice address

7 Grandview LN
Smithtown, NY 11787-4231

Phone

(631) 987-9208

NPI assigned

Oct 22, 2015

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

• Katrina M Frank Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 29, 2019.

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1831561471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 TERRACE LN",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117722146",
            "telephone_number": "631-987-9208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 GRANDVIEW LN",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874231",
            "telephone_number": "631-987-9208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGTUCA",
        "first_name": "KATRINA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-22",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "037716-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATRINA",
            "last_name": "FRANK",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Smithtown, NY
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2019; 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.