Organization Active NPI

Hennessy Pta PLLC

  • Physical Therapy Clinic/Center
  • New York, NY
National Provider Identifier
1407726425
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
HENNESSY PTA PLLC
Practice address
226 E 54TH St Ste 501
New York, NY 10022-4854
Phone
(917) 848-3594
Fax
(917) 848-3594
NPI assigned
Nov 5, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Authorized official

Name
Ann Marie Hennessy, PTA
Title
Owner
Phone
(917) 848-3594

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

226 E 54TH St Ste 501
New York, NY 10022-4854

Mailing address

3215 30TH St Apt B45
Astoria, NY 11106-2978
Phone (917) 848-3594

Other practice location 1

3215 30th St Apt B45
Astoria, NY 11106-2978
Phone (917) 848-3594

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260227001461 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5496236309 Receives reassigned benefits from 2 practitioners
Practice locations: Astoria, NY

National Provider Directory

National Provider Directory

Locations

226 E 54th St
Ste 501
New York, NY 10022
Phone (212) 308-2990

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1762300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762300800000",
    "number": "1407726425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 30TH ST APT B45",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111062978",
            "telephone_number": "917-848-3594",
            "fax_number": "917-848-3594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 E 54TH ST STE 501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100224854",
            "telephone_number": "917-848-3594",
            "fax_number": "917-848-3594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3215 30th St Apt B45",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "NY",
            "postal_code": "111062978",
            "country_code": "US",
            "telephone_number": "917-848-3594",
            "fax_number": "917-848-3594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HENNESSY PTA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-05",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A",
        "authorized_official_last_name": "HENNESSY",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-848-3594",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; 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.

Verify at the official NPI Registry.