Individual provider Active NPI

Tyler Joseph Kenton, DPT

  • Orthopedic Physical Therapist
  • New York, NY
National Provider Identifier
1598249252
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
038370 Issued in NY
Practice address
666 Broadway Lowr Level
New York, NY 10012-2317
Phone
(302) 233-1210
Fax
(332) 777-1315
NPI assigned
Sep 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 038370 NY Primary

Addresses

Primary practice location

666 Broadway Lowr Level
New York, NY 10012-2317

Mailing address

129 N 3Rd St Apt 309
Brooklyn, NY 11249-3980
Phone (302) 233-1210

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260324003371 FL Practitioner - Physical Therapist in Private Practice 4183108418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Physical Therapy Sport Medicine IncGroup PAC ID 3173413549, 37 clinicians

Practice addresses (Care Compare)

897 NE Jensen Beach Blvd
Jensen Beach, FL 34957-4799
Phone (772) 324-3080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038370NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Tyler J Kenton DPT PLLC Orthopedic CurrentSince Dec 1, 2019 Accepting new patients

Locations

1 Union Sq W
Bsmt
New York, NY 10003

666 Broadway
Lowr
New York, NY 10012
Phone (302) 233-1210

Organizations & group practices 2

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": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1598249252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 N 3RD ST APT 309",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112493980",
            "telephone_number": "302-233-1210",
            "fax_number": "332-777-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 BROADWAY LOWR LEVEL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122317",
            "telephone_number": "302-233-1210",
            "fax_number": "332-777-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENTON",
        "first_name": "TYLER",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-19",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "038370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.