Active NPI
James R McKenna, PA
- Physician Assistant
- Vestal, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 004954
- Practice address
- 3101 Shippers Rd
Vestal, NY 13850-2080 - Phone
- (607) 250-2180
- NPI assigned
- May 14, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 004954 | NY | Primary |
Addresses
Primary practice location
3101 Shippers Rd
Vestal, NY 13850-2080
Mailing address
9 Carey Rd
Queensbury, NY 12804-7880
Phone (518) 761-0300
Other practice location 1
100 Broad St
Glens Falls, NY 12801-4349
Phone (518) 792-2223
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03701062 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | james.mckenna@direct.lourdes.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1302 E Main St
Endicott, NY 13760-5430
Phone (607) 754-2323
4417 Vestal Pkwy E
Vestal, NY 13850-3556
Phone (607) 770-7365
4433 Vestal Pkwy E
Vestal, NY 13850-3556
Phone (607) 771-2220
474 Route 3
Plattsburgh, NY 12901-6538
Phone (518) 536-3071
54 Main St
Candor, NY 13743-1619
Phone (607) 659-7272
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Our Lady of Lourdes Memorial Hospital, Inc. | Current | Accepting new patients | |
| Our Lady of Lourdes Memorial Hospital, Inc. | Physician Assistant | Current | Accepting new patients |
| United Health Services Hospitals, Inc. | Current | Accepting new patients |
Locations
169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111
33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156
169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701
3101 Shippers Rd
Vestal, NY 13850
Phone (607) 250-2180
Interoperability endpoints
- jmckenna196794@direct-guthrie.org
Organizations & group practices 6
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.
-
- Multi-Specialty Clinic/Center
- Johnson City, NY
- NPI 1962463851
-
- Urgent Care Clinic/Center
- Liverpool, NY
- NPI 1669825162
-
- General Acute Care Hospital
- Binghamton, NY
- NPI 1629087580
-
- Emergency Medicine Physician
- Lake Placid, NY
- NPI 1962472514
-
- Family Medicine Physician
- Binghamton, NY
- NPI 1063557189
Physician Assistant
-
- Specialty Pharmacy
- Johnson City, NY
- NPI 1730982596
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Binghamton, NY
- NPI 1518998699
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673913600000",
"number": "1578730008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 CAREY RD",
"city": "QUEENSBURY",
"state": "NY",
"postal_code": "128047880",
"telephone_number": "518-761-0300",
"fax_number": "518-824-2388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3101 SHIPPERS RD",
"city": "VESTAL",
"state": "NY",
"postal_code": "138502080",
"telephone_number": "607-250-2180"
}
],
"practiceLocations": [
{
"address_1": "100 Broad St",
"address_purpose": "LOCATION",
"city": "Glens Falls",
"state": "NY",
"postal_code": "128014349",
"country_code": "US",
"telephone_number": "518-792-2223",
"fax_number": "518-792-8231",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCKENNA",
"first_name": "JAMES",
"middle_name": "R",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-14",
"last_updated": "2023-01-17",
"certification_date": "2023-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "004954",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03701062",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "james.mckenna@direct.lourdes.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "3101 Shippers Rd",
"city": "Vestal",
"state": "NY",
"country_code": "US",
"postal_code": "138502080",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Vestal, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.