Jenna Joy Kennedy, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

037379 Issued in NY

Practice address

77 Medford Ave
Patchogue, NY 11772-1281

Phone

(631) 758-1910

Fax

(631) 758-2371

NPI assigned

Mar 4, 2014

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

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proactive Care Physical Therapy, PCGroup PAC ID 9133276058, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Proactive Care Physical Therapy, PC

  • Physical Therapy Clinic/Center
  • Bohemia, NY
  • NPI 1528210390
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1437574175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MORGAN LN",
            "city": "BAYPORT",
            "state": "NY",
            "postal_code": "117052230",
            "telephone_number": "631-838-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 MEDFORD AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721281",
            "telephone_number": "631-758-1910",
            "fax_number": "631-758-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JENNA",
        "middle_name": "JOY",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-04",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "037379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Keegan
• Julia Louise Keene, PHD, BCBA-D, LBA
• Kaitlyn Kelly, MT-BC, LCAT
• Jennifer Lynn Kelsch, LCSW-R
• William Keltz, DPT
• Amanda Kern
• Lydia L Kessel, OTD, OTR/L
• Emily Rose Kettell, LMSW
• Monica Lisa Khalil, M.D.
• Ayesha Khan, MD

• Physical Therapist in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; 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.