Individual provider Active NPI

Makenzie L Konik, OTR/L

  • Occupational Therapist
  • Scotia, NY
National Provider Identifier
1730066044
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
030372 Issued in NY
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

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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, PLLCGroup PAC ID 5092730788, 84 clinicians

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

LicenseStateTypeSpecialty
030372NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
PRN Physical, Occupational and Speech Therapy Network, PLLC CurrentSince Aug 25, 2025 Accepting new patients
PRN Physical, Occupational and Speech Therapy Network, PLLC CurrentSince Aug 25, 2025 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.

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.

Verify at the official NPI Registry.