KATHERINE ANTZOULATOS, DPM, RD, CDN — NPI 1366908139 (Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Primary Podiatric Medicine in WHITESTONE, NY)

CMS-1500 Box 24J / 33a • NPI

1366908139

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

213EP1101X (CMS 48)

Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Primary Podiatric Medicine

Box 32 Service Location & ZIP+4

915 150TH ST, WHITESTONE, NY, 11357-1653

✓ 9-Digit EDI 837 ZIP+4 (11357-1653)

Practice Phone & Referral Fax

(347) 642-0315

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1366908139 (KATHERINE ANTZOULATOS, DPM, RD, CDN) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1366908139` (NPI-1 Individual Practitioner)
Provider / Legal Name	KATHERINE ANTZOULATOS, DPM, RD, CDN
Plain-English Specialty	Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Primary Podiatric Medicine NUCC Code: `213EP1101X` (Podiatrist, Primary Podiatric Medicine)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	915 150TH ST, WHITESTONE, NY, 11357-1653
Practice Telephone / Fax	Tel: (347) 642-0315
Administrative Mailing Address	915 150TH ST, WHITESTONE, NY, 11357-1653
Enumeration & Last Sync	Enumerated: 2019-02-15 \| CMS Record Updated: 2019-02-15

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

915 150TH ST, WHITESTONE, NY, 11357-1653

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Plain-English Taxonomy & CMS Crosswalk (213EP1101X)

What Does Taxonomy Code 213EP1101X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 213EP1101X translates to:
"Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Primary Podiatric Medicine"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 48 (Podiatry)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Podiatrist, Primary Podiatric Medicine for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (KATHERINE ANTZOULATOS, DPM, RD, CDN)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`133V00000X` — Dietitian, Registered Plain English: Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered	State: NY \| License: `1000889` \| Primary: Secondary
`213EP1101X` — Podiatrist, Primary Podiatric Medicine Plain English: Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Primary Podiatric Medicine	State: NY \| License: `N004198` \| Primary: Yes (Primary)

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KATHERINE ANTZOULATOS, DPM, RD, CDN (NPI #1366908139)