Individual provider Active NPI

Ryan Kennedy, DPT

  • Physical Therapist
  • Greenacres, FL
National Provider Identifier
1629627740
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT37122 Issued in FL
Practice address
6724 Forest Hill Blvd
Greenacres, FL 33413-3335
Phone
(561) 433-2009
NPI assigned
Sep 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT37122 FL Primary
Physical Therapist 225100000X 044900 NY

Addresses

Primary practice location

6724 Forest Hill Blvd
Greenacres, FL 33413-3335

Mailing address

15 Apex Dr
Highland, IL 62249-1282
Phone (618) 651-0444

Other practice location 1

279 Sunrise Hwy
Rockville Centre, NY 11570-4925
Phone (516) 255-4263

Other identifiers 1

IdentifierTypeStateIssuer
PT37122OtherFLSTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210621001191 FL Practitioner - Physical Therapist in Private Practice 0244569424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apex Physical Therapy, LLCGroup PAC ID 2264423458, 104 clinicians

Practice addresses (Care Compare)

6724 Forest Hill Blvd
Greenacres, FL 33413-3335
Phone (561) 433-2009

Merit-based Incentive Payment System (MIPS)

Final score
76.03 of 100Reported as group
Quality
74.47
Improvement activities
40
Cost
66.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
044900NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Physical Therapy, LLC Physical Therapist CurrentSince May 19, 2021 Accepting new patients
Apex Physical Therapy, LLC Physical Therapist CurrentSince May 19, 2021 Accepting new patients

Locations

6724 Forest Hill Blvd
Greenacres, FL 33413
Phone (561) 433-2009

15 Apex Dr
Highland, IL 62249
Phone (618) 441-0482

Networks

  • Freedom Health HMO Network

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": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1629627740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 APEX DR",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491282",
            "telephone_number": "618-651-0444",
            "fax_number": "618-654-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6724 FOREST HILL BLVD",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334133335",
            "telephone_number": "561-433-2009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "279 Sunrise Hwy",
            "address_purpose": "LOCATION",
            "city": "Rockville Centre",
            "state": "NY",
            "postal_code": "115704925",
            "country_code": "US",
            "telephone_number": "516-255-4263",
            "fax_number": "516-255-4050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "RYAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-11",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT37122",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "044900",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PT37122",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenacres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.