Individual provider Active NPI

Thomas J McKenna, M.D.

  • Gastroenterology Physician
  • Bryn Mawr, PA
National Provider Identifier
1063724490
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD438041 Issued in PA
Practice address
825 Old Lancaster Rd
Suite 320
Bryn Mawr, PA 19010-3231
Phone
(610) 525-9570
Fax
(610) 527-0334
NPI assigned
Jul 14, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD438041 PA Primary

Addresses

Primary practice location

825 Old Lancaster Rd
Suite 320
Bryn Mawr, PA 19010-3231

Mailing address

825 Old Lancaster Rd
Suite 320
Bryn Mawr, PA 19010-3231
Phone (610) 525-9570

Other identifiers 1

IdentifierTypeStateIssuer
1030956550001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101005000408 PA Practitioner - Gastroenterology 9830381102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Temple University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bryn Mawr Medical Specialists AssociationGroup PAC ID 4183610934, 135 clinicians

Practice addresses (Care Compare)

825 Old Lancaster Rd
Suite 320
Bryn Mawr, PA 19010-3235
Phone (610) 527-3800

Hospital & facility affiliations

  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
  • Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
  • Paoli Hospital Hospital, Paoli, PA, CCN 390153
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy381
Upper gastrointestinal (GI) endoscopy for acid reflux244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD438041PAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bryn Mawr Medical Specialists Association CurrentSince Jul 1, 2010 Accepting new patients

Locations

825 Old Lancaster Rd
Ste 340
Bryn Mawr, PA 19010
Phone (610) 525-9570

825 Old Lancaster Rd
Ste 320
Bryn Mawr, PA 19010
Phone (610) 524-3800

Interoperability endpoints

  • Direct secure messaging: thomas.mckenna@bmmsa.directbygreenway.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1063724490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 OLD LANCASTER RD",
            "address_2": "SUITE 320",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103231",
            "telephone_number": "610-525-9570",
            "fax_number": "610-527-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 OLD LANCASTER RD",
            "address_2": "SUITE 320",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103231",
            "telephone_number": "610-525-9570",
            "fax_number": "610-527-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-14",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD438041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030956550001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.