1. Home
  2. Directory
  3. New York
  4. Manhasset
  5. Clinical Neuropsychologist
  6. NPI Profile

KATHRYN MIRRA PHD
NPI 1720373657
Clinical Neuropsychologist in Manhasset, NY

Active since June 20, 2011PECOS Enrolled
1554 NORTHERN BLVD FL 3, MANHASSET, NY 11030(516) 719-3700 Get Directions Write a Review

NPPES record last updated: July 27, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kathryn Mirra Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHRYN MIRRA PHD (NPI 1720373657) is an individual clinical neuropsychologist in Manhasset, New York, licensed in New York (020150) and active in the NPI registry since June 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720373657
Entity TypeIndividualFemale
Primary Taxonomy103G00000X
Provider Legal NameKATHRYN MIRRACredential: PHD
Location Address1554 NORTHERN BLVD FL 3Manhasset, NY 11030-3054
Mailing Address1554 Northern Blvd Fl 3Manhasset, NY 11030-3054 · (516) 719-3799
Phone(516) 719-3700
Sole ProprietorNo
Enumeration DateJune 20, 2011
Last NPPES UpdateJuly 27, 2023
NPPES CertifiedJuly 27, 2023
✔ NPI 1720373657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License✔ Licensed in NY · 020150
Definition
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
1554 NORTHERN BLVD FL 3, Manhasset, NY 11030
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathryn Mirra Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kathryn Mirra reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sports Physical Therapy Occupational Therapy And Rehabilitation Servic
9.0 mi
Hand
801 MERRICK AVE
East Meadow, NY 11554
  • Reassigned Medicare billing, New York enrollment
  • 795 clinicians in this Medicare group
NPI 1770540593 (516) 393-8900

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAITLIN M AIREY
Physical Therapist
1554 NORTHERN BLVD FL 3
MANHASSET, NY 11030
Nassau County (516) 719-3700
CHRISTINA MASIAKOS MA, CCC-SLP
Speech-Language Pathologist
1554 NORTHERN BLVD FL 3
MANHASSET, NY 11030
Nassau County (516) 719-3700
JENNIFER ARBITMAN
Speech-Language Pathologist
1554 NORTHERN BLVD FL 3
MANHASSET, NY 11030
Nassau County (516) 719-3700
ANN MARIE PANAGOS SLP
Speech-Language Pathologist
1554 NORTHERN BLVD FL 3
MANHASSET, NY 11030
Nassau County (516) 719-3700
YAMEI HUANG PT,DPT
Physical Therapist
1554 NORTHERN BLVD FL 3
MANHASSET, NY 11030
Nassau County (516) 719-3700
JESSICA SHULMAN PT,DPT
Physical Therapist
1554 NORTHERN BLVD FL 3
MANHASSET, NY 11030
Nassau County (516) 719-3700
GINU JOSE
Speech-Language Pathologist
1554 NORTHERN BLVD FL 3
MANHASSET, NY 11030
Nassau County (516) 719-3723
SAMUEL WONG PT,DPT
Physical Therapist
1554 NORTHERN BLVD FL 3
MANHASSET, NY 11030
Nassau County (516) 719-3700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kathryn Mirra's NPI number?

The NPI number for Kathryn Mirra is 1720373657. It was assigned to this individual provider in the NPPES registry on June 20, 2011.

Where is Kathryn Mirra located?

Kathryn Mirra practices at 1554 Northern Blvd Fl 3, Manhasset, NY 11030. The listed phone number is (516) 719-3700.

What is Kathryn Mirra's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Kathryn Mirra enrolled in Medicare?

Yes. Kathryn Mirra is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kathryn Mirra's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kathryn Mirra reassigns Medicare benefits to Sports Physical Therapy Occupational Therapy And Rehabilitation Servic (East Meadow, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kathryn Mirra's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kathryn Mirra was last updated on July 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.