Active NPI
Makenzie L Konik, OTR/L
- Occupational Therapist
- Scotia, NY
National Provider Identifier
1730066044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 030372
- Practice address
- 777 Swaggertown Rd
Scotia, NY 12302-9531 - Phone
- (518) 858-8029
- NPI assigned
- Aug 19, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 030372 | NY | Primary |
Addresses
Primary practice location
777 Swaggertown Rd
Scotia, NY 12302-9531
Mailing address
777 Swaggertown Rd
Scotia, NY 12302-9531
Phone (518) 858-8029
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250923002688 | NY | Practitioner - Occupational Therapist in Private Practice | 0648775585 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- PRN Physical, Occupational and Speech Therapy Network, PLLC
Practice addresses (Care Compare)
59 Harris Rd
Troy, NY 12182-3406
Phone (518) 669-9033
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 030372 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PRN Physical, Occupational and Speech Therapy Network, PLLC | Current | Accepting new patients | |
| PRN Physical, Occupational and Speech Therapy Network, PLLC | Current | Accepting new patients |
Locations
2222 Sullivan Trl
Ste 105
Easton, PA 18040
Phone (574) 261-7058
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.
-
- Physical Therapist
- East Greenbush, NY
- NPI 1336185263
NY
-
- Durable Medical Equipment & Medical Supplies
- Troy, NY
- NPI 1568059665
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755561600000",
"number": "1730066044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 SWAGGERTOWN RD",
"city": "SCOTIA",
"state": "NY",
"postal_code": "123029531",
"telephone_number": "518-858-8029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 SWAGGERTOWN RD",
"city": "SCOTIA",
"state": "NY",
"postal_code": "123029531",
"telephone_number": "518-858-8029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONIK",
"first_name": "MAKENZIE",
"middle_name": "L",
"name_prefix": "Miss",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-08-19",
"last_updated": "2025-08-19",
"certification_date": "2025-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "030372",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Scotia, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.