Individual provider Active NPI

Jonathan Lucero McKinney, PA-C

  • Physician Assistant
  • Providence, RI
National Provider Identifier
1144951369
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01489 Issued in RI
Practice address
825 Chalkstone Ave
Providence, RI 02908-4728
Phone
(401) 456-2000
NPI assigned
Jun 20, 2022
Last updated
Mar 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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 PA01489 RI Primary

Addresses

Primary practice location

825 Chalkstone Ave
Providence, RI 02908-4728

Mailing address

40 Princeton Ave
Providence, RI 02907-4115
Phone (717) 673-7066

Other practice location 1

40 Princeton Ave
Providence, RI 02907-4115
Phone (717) 673-7066

Other practice location 2

200 High Service Ave
North Providence, RI 02904-5113
Phone (401) 456-3000

Other practice location 3

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

Other practice location 4

21 Division St
Pawtucket, RI 02860-5352
Phone (401) 727-4800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmckinney@kent.cernerdirect.carene.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20250529002649 FL Practitioner - Physician Assistant 8527434786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12500 S Apopka Vineland Rd
Orlando, FL 32836-6723
Phone (407) 934-2273

440 W Hwy 436
Adventhealth Centra Care Altamonte
Altamonte Springs, FL 32714-4136
Phone (407) 788-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System/ Sunbelt, Inc. Physician Assistant CurrentSince May 13, 2025 Accepting new patients
Adventist Health System/Sunbelt, Inc. Physician Assistant CurrentSince May 13, 2025 Accepting new patients

Locations

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

2600 Westhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 200-1353

Interoperability endpoints

  • Direct secure messaging: jmckinney@kent.cernerdirect.carene.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1144951369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 PRINCETON AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029074115",
            "telephone_number": "717-673-7066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728",
            "telephone_number": "401-456-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Princeton Ave",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029074115",
            "country_code": "US",
            "telephone_number": "717-673-7066",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 High Service Ave",
            "address_purpose": "LOCATION",
            "city": "North Providence",
            "state": "RI",
            "postal_code": "029045113",
            "country_code": "US",
            "telephone_number": "401-456-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Toll Gate Rd",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028862759",
            "country_code": "US",
            "telephone_number": "401-737-7010",
            "fax_number": "401-736-4546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21 Division St",
            "address_purpose": "LOCATION",
            "city": "Pawtucket",
            "state": "RI",
            "postal_code": "028605352",
            "country_code": "US",
            "telephone_number": "401-727-4800",
            "fax_number": "401-921-6924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "JONATHAN",
        "middle_name": "LUCERO",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-20",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmckinney@kent.cernerdirect.carene.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "455 Toll Gate Rd",
            "city": "Warwick",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028862759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.