Active NPI
Physician Management Services of New York, LLC
- Family Medicine Physician
- Monroe, NY
National Provider Identifier
1306334552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- PHYSICIAN MANAGEMENT SERVICES OF NEW YORK, LLC
- Practice address
- 1200 State Route 208
Monroe, NY 10950-4648 - Phone
- (888) 829-8550
- NPI assigned
- Apr 24, 2018
- Organization subpart
- Yes
- Parent organization
- VAXCARE CORPORATION
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brett Kenefick
- Title
- President
- Phone
- (888) 829-8550
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | NY | Primary |
Addresses
Primary practice location
1200 State Route 208
Monroe, NY 10950-4648
Mailing address
800 N Magnolia Ave Ste 700
Orlando, FL 32803-3264
Phone (888) 829-8550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190819002544 | TX | Part B Supplier - Centralized Flu Biller | 0547598328 | Practice locations: Monroe, NY |
National Provider Directory
National Provider Directory- Part of
- Vaxcare Corporation
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524528000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1779321600000",
"number": "1306334552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 N MAGNOLIA AVE STE 700",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328033264",
"telephone_number": "888-829-8550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 STATE ROUTE 208",
"city": "MONROE",
"state": "NY",
"postal_code": "109504648",
"telephone_number": "888-829-8550"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHYSICIAN MANAGEMENT SERVICES OF NEW YORK, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "VAXCARE CORPORATION",
"enumeration_date": "2018-04-24",
"last_updated": "2026-05-21",
"certification_date": "2026-05-21",
"status": "A",
"authorized_official_last_name": "KENEFICK",
"authorized_official_first_name": "BRETT",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "888-829-8550"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "NY",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.