NPIMap

Individual provider Active NPI

James Joseph McKenna IV, PA-C

  • Physician Assistant
  • Scranton, PA
National Provider Identifier
1538892260
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA063686 Issued in PA
Practice address
300 Lackawanna Ave Ste 200
Scranton, PA 18503-2001
Phone
(570) 342-7864
NPI assigned
Jul 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA063686 PA Primary

Addresses

Primary practice location

300 Lackawanna Ave Ste 200
Scranton, PA 18503-2001

Mailing address

2100 Mack Blvd FL 2
Allentown, PA 18103-5622
Phone (484) 884-4500

Other practice location 1

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231013000281 NY Practitioner - Physician Assistant 8729455936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

169 Riveride Dr
Binghamton, NY 13905-4246

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Tier Pathology Associates, PC Current Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Oct 30, 2023 Accepting new patients
Our Lady of Lourdes Memorial Hospital Inc. CurrentSince Oct 30, 2023 Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. Physician Assistant Current Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701

500 5th Ave
Owego, NY 13827
Phone (607) 687-1122

Interoperability endpoints

  • Direct secure messaging: jmckenna196769@direct-guthrie.org

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1657324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1538892260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 2",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-884-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LACKAWANNA AVE STE 200",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185032001",
            "telephone_number": "570-342-7864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Academy Ave",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "PA",
            "postal_code": "178229800",
            "country_code": "US",
            "telephone_number": "570-271-6590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "JAMES",
        "middle_name": "JOSEPH",
        "name_suffix": "IV",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-09",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA063686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.