Active NPI
Katia Derthick, CNM
- Advanced Practice Midwife
- New York, NY
National Provider Identifier
1962986299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- CNM05134
- Practice address
- 726 Broadway FL 4
New York, NY 10003-9616 - Phone
- (212) 443-1000
- NPI assigned
- Sep 21, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | CNM05134 | NY | Primary |
Addresses
Primary practice location
726 Broadway FL 4
New York, NY 10003-9616
Mailing address
394 Lincoln PL Apt C3
Brooklyn, NY 11238-5819
Phone (828) 545-0395
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
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNM05134 | NY | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537488000000",
"number": "1962986299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "394 LINCOLN PL APT C3",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112385819",
"telephone_number": "828-545-0395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "726 BROADWAY FL 4",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100039616",
"telephone_number": "212-443-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERTHICK",
"first_name": "KATIA",
"name_prefix": "Ms.",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-21",
"last_updated": "2018-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "NY",
"license": "CNM05134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.