Active NPI
Kevin Anthony Menard, LAC
- Acupuncturist
- Sag Harbor, NY
National Provider Identifier
1134482730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 004842-1
- Practice address
- 39 Division St
Sag Harbor, NY 11963-3156 - Phone
- (917) 689-2153
- NPI assigned
- Jun 19, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 004842-1 | NY | Primary |
Addresses
Primary practice location
39 Division St
Sag Harbor, NY 11963-3156
Mailing address
PO Box 2271
Sag Harbor, NY 11963-0112
Phone (917) 689-2153
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004842-1 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403740800000",
"number": "1134482730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2271",
"city": "SAG HARBOR",
"state": "NY",
"postal_code": "119630112",
"telephone_number": "917-689-2153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39 DIVISION ST",
"city": "SAG HARBOR",
"state": "NY",
"postal_code": "119633156",
"telephone_number": "917-689-2153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENARD",
"first_name": "KEVIN",
"middle_name": "ANTHONY",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-19",
"last_updated": "2014-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "004842-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sag Harbor, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.