Individual provider Active NPI

Makenna Thisse, DPT

  • Physical Therapist
  • Penn Yan, NY
National Provider Identifier
1598673477
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
056412 Issued in NY
Practice address
207 1/2 Lake St
Penn Yan, NY 14527-1802
Phone
(315) 536-4051
NPI assigned
Aug 31, 2026
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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 056412 NY Primary

Addresses

Primary practice location

207 1/2 Lake St
Penn Yan, NY 14527-1802

Mailing address

207 1/2 Lake St
Penn Yan, NY 14527-1802
Phone (315) 536-4051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1598673477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 1/2 LAKE ST",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271802",
            "telephone_number": "315-536-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 1/2 LAKE ST",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271802",
            "telephone_number": "315-536-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THISSE",
        "first_name": "MAKENNA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "056412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penn Yan, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.