Meagan Kimberly Gementiza Kannenberg

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

029561 Issued in NY

Practice address

333 Seventh Ave Ny Ny
New York, NY 10001

Phone

(917) 415-9310

NPI assigned

Oct 24, 2024

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

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Functional Movement Therapeutics LLCGroup PAC ID 3678095973, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Functional Movement Therapeutics LLC

  • Physical Therapist
  • New Rochelle, NY
  • NPI 1285445312
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1427879170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 SEVENTH AVE NY NY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10001",
            "telephone_number": "917-415-9310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SEVENTH AVE NY NY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10001",
            "telephone_number": "917-415-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNENBERG",
        "first_name": "MEAGAN KIMBERLY",
        "middle_name": "GEMENTIZA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "029561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dulani Kankanamge
• Shashwati Kankaria, PT, DPT
• Rajni Kannan
• Nivedha Vishali Kannapadi
• Vikas Kanneganti
• Cara Hadar Kanner, PT
• Jed S Kanner, DDS
• Lisa Kanner, LCSW
• Neil G Kanner, DMD
• Anne K Kanninen, L.AC.

• Occupational Therapist in New York, NY
• Providers in New York, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.