Active NPI
Shaun Lennon
- Physical Therapist
- Kings Park, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 265 Indian Head Rd
Kings Park, NY 11754-4803 - Phone
- (631) 528-5011
- NPI assigned
- May 9, 2025
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
265 Indian Head Rd
Kings Park, NY 11754-4803
Mailing address
20 Ridge Rd
Smithtown, NY 11787-2506
Phone (631) 624-3265
Other practice location 1
131 W Main St
Bay Shore, NY 11706-8315
Phone (631) 665-4560
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
265 Indian Head Rd
Suite 101
Kings Park, NY 11754-4803
Phone (631) 863-9560
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 054555 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Occupational & Physical Therapy, PLLC | Physical Therapist | Current | Accepting new patients |
| Professional Occupational & Physical Therapy, PLLC | Physical Therapist | Current | Accepting new patients |
| Professional Occupational & Physical Therapy, PLLC | Physical Therapist | Current | Accepting new patients |
Locations
123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248
265 Indian Head Rd
Ste 101
Kings Park, NY 11754
Phone (631) 863-9560
576 Broadhollow Rd
Melville, NY 11747
2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610
Organizations & group practices 3
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.
-
- Occupational Therapist
- Rockville Centre, NY
- NPI 1205296902
Physical Therapist
-
- Occupational Therapist
- Whitestone, NY
- NPI 1487104261
Physical Therapist
-
- Occupational Therapist
- Randolph, NJ
- NPI 1104376680
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1746748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746748800000",
"number": "1760272017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 RIDGE RD",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117872506",
"telephone_number": "631-624-3265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "265 INDIAN HEAD RD",
"city": "KINGS PARK",
"state": "NY",
"postal_code": "117544803",
"telephone_number": "631-528-5011"
}
],
"practiceLocations": [
{
"address_1": "131 W Main St",
"address_purpose": "LOCATION",
"city": "Bay Shore",
"state": "NY",
"postal_code": "117068315",
"country_code": "US",
"telephone_number": "631-665-4560",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LENNON",
"first_name": "SHAUN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-05-09",
"last_updated": "2025-05-09",
"certification_date": "2025-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kings Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.