Kenna Marie Koenigsberger

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

177 Fort Washington Ave
New York, NY 10032-3733

Phone

(631) 418-6915

NPI assigned

Nov 25, 2020

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

Enrolled in NY

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

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: kek9080@direct.nyp.org

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.

• North Shore Hematology Oncology Associates PC

  • Specialist
  • Port Jefferson Station, NY
  • NPI 1396794574
  Medicare reassignment

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

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1316541741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 ALICIA DR",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117034043",
            "telephone_number": "631-418-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323733",
            "telephone_number": "631-418-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIGSBERGER",
        "first_name": "KENNA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-25",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Koenigsberg, DDS
• Elizabeth Trainor Koenigsberg, LCSW
• Julie Koenigsberg
• Rebecca Koenigsberg
• Dorcas Koenigsberger
• Koepke Counseling Services, Licensed Mental Health Counseling, PC (Restore Renew Therapy)
• Kayle Koepke, LMHC
• Deborah Koeppel, LCSW-R
• Joanna Darcy Koeppel, LMSW
• John Lawrence Koeppel, LCSW

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.