Individual provider Active NPI

Allison Keneski, RPA-C

  • Physician Assistant
  • Riverhead, NY
National Provider Identifier
1104091024
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
012452-1 Issued in NY
Practice address
550 E Main St
Riverhead, NY 11901-2672
Phone
(631) 591-3093
Fax
(631) 317-1010
NPI assigned
Apr 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 012452-1 NY Primary

Addresses

Primary practice location

550 E Main St
Riverhead, NY 11901-2672

Mailing address

550 E Main St
Riverhead, NY 11901-2672
Phone (631) 591-3093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110309000064 NY Practitioner - Physician Assistant 3476735622 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
Roslyn, NY 11576-1347

1000 N Village Ave
Rockville Center, NY 11570-1000

200 Belle Terre Rd
Port Jefferson, NY 11777-1928

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
012452-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, PC CurrentSince Dec 19, 2023 Accepting new patients
CHS Physician Partners, P.C CurrentSince Dec 19, 2023 Accepting new patients

Locations

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

5972 Route 25A
Wading River, NY 11792
Phone (631) 910-7100

Interoperability endpoints

  • Direct secure messaging: akeneski160284@direct-chsli.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1104091024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 E MAIN ST",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012672",
            "telephone_number": "631-591-3093",
            "fax_number": "631-317-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E MAIN ST",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012672",
            "telephone_number": "631-591-3093",
            "fax_number": "631-317-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENESKI",
        "first_name": "ALLISON",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-23",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012452-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

Verify at the official NPI Registry.