Individual provider Active NPI

Bryon McKenna, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Thibodaux, LA
National Provider Identifier
1396108759
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
36.003919 Issued in OH
Practice address
290 Bowie Rd
Thibodaux, LA 70301-6712
Phone
(985) 493-4990
Fax
(985) 493-4991
NPI assigned
Apr 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 36.003919 OH Primary

Addresses

Primary practice location

290 Bowie Rd
Thibodaux, LA 70301-6712

Mailing address

3323 S Snowflake Way
Boise, ID 83706-5261
Phone (208) 860-2584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200824000009 LA Practitioner - Podiatry 8426382771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thibodaux Regional Network Development CorporationGroup PAC ID 8224011754, 138 clinicians

Practice addresses (Care Compare)

290 Bowie Rd
Suite a
Thibodaux, LA 70301-6712
Phone (985) 493-4140

Hospital & facility affiliations

  • Thibodaux Regional Medical Center Hospital, Thibodaux, LA, CCN 190004

Merit-based Incentive Payment System (MIPS)

Final score
82.55 of 100Reported as group
Quality
67.62
Promoting interoperability
100
Improvement activities
40
Cost
71.34

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue32
Removal of skin lesions1-10
Removal of nail tissue46
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thibodaux Regional Network Development Corporation CurrentSince Sep 1, 2020 Accepting new patients
Thibodaux Regional Network Development Corporation Current Accepting new patients
Thibodaux Regional Network Development Corporation Foot & Ankle Surgery CurrentSince Sep 1, 2020 Accepting new patients
Thibodaux Regional Network Development Corporation Past Accepting new patients

Locations

1238 Saint Charles St
Houma, LA 70360
Phone (985) 872-9430

290 Bowie Rd
Ste A
Thibodaux, LA 70301
Phone (985) 493-4140

290 Bowie Rd
Thibodaux, LA 70301
Phone (985) 493-4990

602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1459641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1396108759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3323 S SNOWFLAKE WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837065261",
            "telephone_number": "208-860-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 BOWIE RD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703016712",
            "telephone_number": "985-493-4990",
            "fax_number": "985-493-4991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "BRYON",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-03",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36.003919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

Verify at the official NPI Registry.