Individual provider Active NPI

Jon L McKenna, MPT

  • Physical Therapist
  • Hopewell Junction, NY
National Provider Identifier
1285790139
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
028690 Issued in NY
Practice address
135 Clove Branch Rd
Hopewell Junction, NY 12533-6183
Phone
(845) 592-4605
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 028690 NY Primary

Addresses

Primary practice location

135 Clove Branch Rd
Hopewell Junction, NY 12533-6183

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050

Other practice location 1

2 Front Street
Millbrook, NY 12545
Phone (845) 677-5021

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070712000778 NY Practitioner - Physical Therapist in Private Practice 7618074154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

135 Clove Branch Rd
Hopewell Junction, NY 12533-6183
Phone (845) 592-4605

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
028690NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Physical Therapist CurrentSince Mar 28, 2022 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince Mar 28, 2022 Accepting new patients
William S. Bremiller Physical Therapist PastSince Nov 22, 2004 Accepting new patients
Harrison Physical Therapy, P.C. Physical Therapist PastSince Feb 26, 2002 Accepting new patients
Catskill Orange Orthopaedics,PC Past Accepting new patients

Locations

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

135 Clove Branch Rd
Hopewell Junction, NY 12533
Phone (845) 223-7438

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

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": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1285790139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 CLOVE BRANCH RD",
            "city": "HOPEWELL JUNCTION",
            "state": "NY",
            "postal_code": "125336183",
            "telephone_number": "845-592-4605"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Front Street",
            "address_purpose": "LOCATION",
            "city": "Millbrook",
            "state": "NY",
            "postal_code": "12545",
            "country_code": "US",
            "telephone_number": "845-677-5021",
            "fax_number": "845-677-3117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "JON",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopewell Junction, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; 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.