Individual provider Active NPI

Amanda McKenna

  • Physical Therapist
  • Providence, RI
National Provider Identifier
1396154464
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT02720 Issued in RI
Practice address
285 Promenade St
Providence, RI 02908-5794
Phone
(401) 459-4008
Fax
(401) 459-4010
NPI assigned
Aug 4, 2014
Last updated
Aug 4, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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 PT02720 RI Primary

Addresses

Primary practice location

285 Promenade St
Providence, RI 02908-5794

Mailing address

285 Promenade St
Providence, RI 02908-5794
Phone (401) 459-4008

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140923002249 RI Practitioner - Physical Therapist in Private Practice 5395964308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedics Rhode Island IncGroup PAC ID 7012225907, 123 clinicians

Practice addresses (Care Compare)

285 Promenade St
Providence, RI 02908-5794
Phone (401) 777-7000

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT02720RIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedics Rhode Island, Inc CurrentSince Oct 7, 2015 Accepting new patients
Orthopedics Rhode Island, Inc Physical Therapist CurrentSince Oct 7, 2015 Accepting new patients

Locations

285 Promenade St
Providence, RI 02908
Phone (401) 459-4001

300 Crossings Blvd
Warwick, RI 02886
Phone (716) 208-1708

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1396154464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 PROMENADE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029085794",
            "telephone_number": "401-459-4008",
            "fax_number": "401-459-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 PROMENADE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029085794",
            "telephone_number": "401-459-4008",
            "fax_number": "401-459-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT02720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; 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.