Katie Mitaszka, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

023902 Issued in NY

Practice address

1901 First Avenue
12TH Floor Room 12A1
New York, NY 10029

Phone

(212) 423-7913

NPI assigned

Jun 24, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1972164606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 GREENPOINT AVE APT 7J",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111044523",
            "telephone_number": "508-667-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 FIRST AVENUE",
            "address_2": "12TH FLOOR ROOM 12A1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "212-423-7913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITASZKA",
        "first_name": "KATIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "023902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Brielle Miszkiewicz, PA-C
• Alyssa-Rae Mita, DDS
• Renu Chawla Mital, MD
• Seema Mital, MD
• Miki Mitarai
• Anne Elizabeth Mitch, CNS,LP
• Nicole Mitch, LMT
• Mitchell a. Kline MD PC
• Mary Ellen Mitchell Haddad, REGISTERED NURSE
• Mitchell J Mandel MDPC

• Surgical Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.