Katherine Antzoulatos, DPM, RD, CDN is a medicare enrolled "Podiatrist - Primary Podiatric Medicine" provider in Whitestone, New York. Her current practice location is
915 150th St, Whitestone, New York. You can reach out to her office (for appointments etc.) via phone at
(347) 642-0315.
Katherine Antzoulatos is licensed to practice in New York (license number N004198) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1366908139.
Healthcare Provider's Profile
| Full Name | Katherine Antzoulatos |
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| Gender | Female |
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| Speciality | Podiatrist - Primary Podiatric Medicine |
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| Location | 915 150th St, Whitestone, New York |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1366908139
- Provider Enumeration Date: 02/15/2019
- Last Update Date: 02/15/2019
Medicare PECOS Information:
- PECOS PAC ID: 6103235205
- Enrollment ID: I20210430001662
Medical Identifiers
Medical identifiers for Katherine Antzoulatos such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1366908139 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | 1000889 (New York) | Secondary |
| 213EP1101X | Podiatrist - Primary Podiatric Medicine | N004198 (New York) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Katherine Antzoulatos allows following entities to bill medicare on her behalf.
| Provider Name | Dr Jay Bienenfeld Dpm Pllc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1396358834
PECOS PAC ID: 5799196549
Enrollment ID: O20201130001025 |
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| Provider Name | Foot Forward Podiatry Pc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1487314332
PECOS PAC ID: 3971995697
Enrollment ID: O20220110000374 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Katherine Antzoulatos is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Katherine Antzoulatos, DPM, RD, CDN
915 150th St,
Whitestone, NY 11357-1653
Ph: (347) 642-0315 | Katherine Antzoulatos, DPM, RD, CDN
915 150th St,
Whitestone, NY 11357-1653
Ph: (347) 642-0315 |
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