Individual provider Active NPI

James R McKenna, PA

  • Physician Assistant
  • Vestal, NY
National Provider Identifier
1578730008
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
004954 Issued in NY
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

Updated by the provider on Jan 17, 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 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

IdentifierTypeStateIssuer
03701062MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140812001439 NY Practitioner - Physician Assistant 4587881776 Reassigns benefits to 4 organizations

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
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

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

OrganizationSpecialtyStatusNew patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince May 18, 2022 Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. Physician Assistant CurrentSince May 18, 2022 Accepting new patients
United Health Services Hospitals, Inc. CurrentSince Apr 21, 2025 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 1

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": "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

Verify at the official NPI Registry.