Kimberly Ann Pena, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

27904 Issued in NY

Practice address

45 Terry Rd
Smithtown, NY 11787-3894

Phone

(516) 903-8145

NPI assigned

Nov 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Physical Therapy and Sport Services, P.C.

  • Physical Therapist
  • Hauppauge, NY
  • NPI 1528135548
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385424000000",
    "number": "1285701730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 HILLS PARK LN",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874062",
            "telephone_number": "631-656-8294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 TERRY RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873894",
            "telephone_number": "516-903-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2013-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "27904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Pavel, M.A.
• Ada Lubell Pazmino, L.C.S.W.
• Richard A Pearl, MD
• Pederson Krag Center
• Denise Pellegrino-Kappel, P.T.
• Lynn Marie Penney, NPP
• Sahana Pentyala, LMSW
• Debra Lynn Peoples, L.M.S.W.
• Jillian Marie Peragallo
• John Pereca, PA-C

• Physical Therapist in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.