Individual provider Active NPI

Jessica Kenaston, MD

  • Anesthesiology Physician
  • Roslyn Heights, NY
National Provider Identifier
1780828319
Registry record updated Nov 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
241545 Issued in NY
Practice address
66 Powerhouse Rd
3Rd Floor
Roslyn Heights, NY 11577-1372
Phone
(516) 945-3000
Fax
(516) 945-3131
NPI assigned
Apr 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 241545 NY Primary

Addresses

Primary practice location

66 Powerhouse Rd
3Rd Floor
Roslyn Heights, NY 11577-1372

Mailing address

68 S Service Rd
Suite 350
Melville, NY 11747-2354
Phone (516) 945-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090528000265 NY Practitioner - Anesthesiology 3072662782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

355 Kear St
Yorktown Heights, NY 10598-4415
Phone (914) 241-1050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
241545NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince May 13, 2011 Accepting new patients
Optum Medical Care, P.C. CurrentSince Apr 12, 2022 Accepting new patients
Optum Medical Care, P.C. CurrentSince Apr 12, 2022 Accepting new patients
North American Partners in Pain Management LLP PastSince Feb 18, 2014 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

243 North Rd
Ste 304
Poughkeepsie, NY 12601
Phone (845) 451-7251

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

355 Kear St
Yorktown Hts, NY 10598
Phone (914) 962-5060

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 4

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": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257120000000",
    "number": "1780828319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 S SERVICE RD",
            "address_2": "SUITE 350",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472354",
            "telephone_number": "516-945-3000",
            "fax_number": "516-945-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 POWERHOUSE RD",
            "address_2": "3RD FLOOR",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115771372",
            "telephone_number": "516-945-3000",
            "fax_number": "516-945-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENASTON",
        "first_name": "JESSICA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-27",
        "last_updated": "2009-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "241545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn Heights, NY

Sources for this page

Verify at the official NPI Registry.