Individual provider Active NPI

Jafar Al Kenany, DPT, ATC

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1144041120
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
054118 Issued in NY
Practice address
142 Prospect Park W
Brooklyn, NY 11215-4506
Phone
(929) 560-9005
NPI assigned
Oct 22, 2024
Last updated
Sep 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT021400 OH
Physical Therapist 225100000X 054118 NY Primary
Athletic Trainer 2255A2300X AT007080 OH

Addresses

Primary practice location

142 Prospect Park W
Brooklyn, NY 11215-4506

Mailing address

666 Woodmont Ave
Berkeley, CA 94708-1234
Phone (650) 391-4986

Other practice location 1

76 Lou Groza Blvd
Berea, OH 44017-1269
Phone (650) 391-4986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251023002081 NY Practitioner - Physical Therapist in Private Practice 5799273413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

142 Prospect Park W
Brooklyn, NY 11215-4506
Phone (718) 230-1180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054118NYMDPhysical Therapist
PT021400OHMDPhysical Therapist
AT007080OHMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince Sep 26, 2025 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Physical Therapist CurrentSince Sep 26, 2025 Accepting new patients

Locations

142 Prospect Park W
Brooklyn, NY 11215
Phone (718) 230-1180

550 Mamaroneck Ave
Ste 104
Harrison, NY 10528
Phone (914) 777-3737

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1729555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1144041120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "666 WOODMONT AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947081234",
            "telephone_number": "650-391-4986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 PROSPECT PARK W",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112154506",
            "telephone_number": "929-560-9005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "76 Lou Groza Blvd",
            "address_purpose": "LOCATION",
            "city": "Berea",
            "state": "OH",
            "postal_code": "440171269",
            "country_code": "US",
            "telephone_number": "650-391-4986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL KENANY",
        "first_name": "JAFAR",
        "credential": "DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-22",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT021400",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "054118",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT007080",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.