Individual provider Active NPI

Katherine Lee Manders, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1922797968
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
031282 Issued in NY
Practice address
161 Fort Washington Ave FL 8
New York, NY 10032-3729
Phone
(212) 305-0444
NPI assigned
May 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 031282 NY Primary

Addresses

Primary practice location

161 Fort Washington Ave FL 8
New York, NY 10032-3729

Mailing address

161 Fort Washington Ave FL 8
New York, NY 10032-3729
Phone (212) 305-0444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240404003018 NY Practitioner - Physician Assistant 6608214945 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Physician Assistant CurrentSince Nov 1, 2024 Accepting new patients
Trustees of Columbia University in the City of New York Physician Assistant CurrentSince Nov 1, 2024 Accepting new patients
Trustees of Columbia University in the City of New York Past Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients

Locations

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

161 Fort Washington Ave
Fl 8
New York, NY 10032
Phone (212) 342-1155

161 Fort Washington Ave
#8
New York, NY 10032
Phone (646) 317-6041

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: yfg9002@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 5

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": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1922797968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 FORT WASHINGTON AVE FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323729",
            "telephone_number": "212-305-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 FORT WASHINGTON AVE FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323729",
            "telephone_number": "212-305-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDERS",
        "first_name": "KATHERINE",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-04",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "031282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.