Individual provider Active NPI

Kevin Palena, PT, DPT, MS

  • Physical Therapist
  • Newark, DE
National Provider Identifier
1508629296
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J1-0014817 Issued in DE
Practice address
425 New London Rd
Newark, DE 19711-7009
Phone
(302) 453-1588
Fax
(302) 453-9705
NPI assigned
Feb 5, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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 J1-0014817 DE Primary

Addresses

Primary practice location

425 New London Rd
Newark, DE 19711-7009

Mailing address

425 New London Rd
Newark, DE 19711-7009
Phone (302) 453-1588

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241014001572 DE Practitioner - Physical Therapist in Private Practice 4880126010 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Hen Physical Therapy, Inc. CurrentSince Feb 11, 2024 Accepting new patients
Physiotherapy Associates Inc CurrentSince Aug 29, 2024 Accepting new patients
Physiotherapy Associates, Inc. Physical Therapist CurrentSince Aug 29, 2024 Accepting new patients
Physiotherapy Associates, Inc. Current Accepting new patients
Blue Hen Physical Therapy, Inc. PastSince Feb 11, 2024 Accepting new patients

Locations

256 Foxhunt Dr
Bear, DE 19701
Phone (302) 834-8650

256 Foxhunt Dr
#50595
Bear, DE 19701
Phone (302) 834-8650

425 New London Rd
Newark, DE 19711
Phone (302) 453-1588

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1508629296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 NEW LONDON RD",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197117009",
            "telephone_number": "302-453-1588",
            "fax_number": "302-453-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 NEW LONDON RD",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197117009",
            "telephone_number": "302-453-1588",
            "fax_number": "302-453-9705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALENA",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0014817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.