Jaclyn McKenna, MD

Primary specialty

Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X

License

322734 Issued in NY

Practice address

1133 Westchester Ave
White Plains, NY 10604-3516

Phone

(914) 821-9296

NPI assigned

May 29, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in RI, NY, CT4 enrollments

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 4

Specialty

Sports Medicine

Education

State University of New York at Stony Brook, School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians

New York Society for the Relief of the Ruptured and Crippled MaintainiGroup PAC ID 2062721350, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hospital for Special Surgery Hospital, New York, NY, CCN 330270
• Stamford Hospital Hospital, Stamford, CT, CCN 070006
• Burke Rehabilitation Hospital Inpatient rehabilitation facility, White Plains, NY, CCN 333030

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2
• FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• New York Society for the Relief of the Ruptured and Crippled Maintaini

  • Orthopaedic Surgery Physician
  • New York, NY
  • NPI 1801282512

  CT

  Medicare reassignment Care Compare group NPD
• New York Society for the Relief of Ruptured & Crippled Maintaining

  • Special Hospital
  • New York, NY
  • NPI 1427496652
  Medicare reassignment NPD
• Ny Society for the Relief of Ruptured & Crippled Maintaining

  • Orthopaedic Surgery Physician
  • New York, NY
  • NPI 1902243488

  CT

  Medicare reassignment NPD
• Lifespan Physician Group, Inc.

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643
  Medicare reassignment NPD
• Lifespan Physician Group, Inc.

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678
  NPD
• New York Society for the Relief of Ruptured & Crippled Maintaining

  • Specialist
  • Paramus, NJ
  • NPI 1417357849
  NPD
• Ny Society for the Relief of Ruptured & Crippled Maintaining

  • Orthopaedic Surgery Physician
  • Paramus, NJ
  • NPI 1982004529
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HSS Westchester

  • Radiology Clinic/Center
  • White Plains, NY
  • NPI 1184159188

  Hospital

  Care Compare affiliation
• New York Society for Relief of the Ruptured and Crippled Maintaining T

  • Radiology Clinic/Center
  • New York, NY
  • NPI 1376032029

  Hospital

  Care Compare affiliation
• New York Society for Relief of the Ruptured and Crippled Maintaining T

  • Radiology Clinic/Center
  • Brooklyn, NY
  • NPI 1487200408

  Hospital

  Care Compare affiliation
• New York Society for Relief of the Ruptured and Crippled Maintaining T

  • Radiology Clinic/Center
  • New York, NY
  • NPI 1801443619

  Hospital

  Care Compare affiliation
• New York Society for the Relief of Ruptured & Crippled Maintaining

  • Radiology Clinic/Center
  • Southampton, NY
  • NPI 1023705803

  Hospital

  Care Compare affiliation
• New York Society for the Relief of Ruptured & Crippled Maintaining

  • General Acute Care Hospital
  • New York, NY
  • NPI 1598703019
  Care Compare affiliation
• New York Society for the Relief of the Ruptured and Crippled

  • Radiology Clinic/Center
  • Uniondale, NY
  • NPI 1629504501

  Hospital

  Care Compare affiliation
• Winifred Masterson Burke Rehabilitation Hospital

  • Rehabilitation Hospital
  • White Plains, NY
  • NPI 1841295219

  Inpatient rehabilitation facility

  Care Compare affiliation
• New York Society for the Relief of Ruptured & Crippled Maintaining

  • General Acute Care Hospital
  • Paramus, NJ
  • NPI 1447082003
  Care Compare affiliation
• New York Society for the Relief of the Ruptured and Crippled

  • General Acute Care Hospital
  • Paramus, NJ
  • NPI 1184038663
  Care Compare affiliation
• New York Society for the Relief of the Ruptured and Crippled

  • Radiology Clinic/Center
  • Stamford, CT
  • NPI 1821402306

  Hospital

  Care Compare affiliation
• Stamford Hospital

  • General Acute Care Hospital
  • Stamford, CT
  • NPI 1356331425
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1871084509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RHODE ISLAND HOSPITAL 593 EDDY STREET",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02903",
            "telephone_number": "401-444-4741",
            "fax_number": "401-444-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 WESTCHESTER AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106043516",
            "telephone_number": "914-821-9296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "JACLYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-29",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP04265",
            "primary": false
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "NY",
            "license": "322734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mckennaj@hss.edu",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1133 Westchester Ave",
            "city": "White Plains",
            "state": "NY",
            "country_code": "US",
            "postal_code": "106043516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "URL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1133 Westchester Ave",
            "city": "White Plains",
            "state": "NY",
            "country_code": "US",
            "postal_code": "106043516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "endpointDescription": "url",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1133 Westchester Ave",
            "city": "White Plains",
            "state": "NY",
            "country_code": "US",
            "postal_code": "106043516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Victoria McGuire, M.S. ED.
• Elizabeth T McGuirk, M.S. CCC-SLP
• Marie Catherine McHenry, FNP
• Dean McKay, PHD
• Mary Josephine McKeever, RN
• Megan McKenna, OT
• Trudi McKenzie
• Brianna McKiernan
• Kevin McKiernan, PHD
• Nichole D McKitty

• Sports Medicine (Internal Medicine) Physician in White Plains, NY
• Providers in White Plains, NY by specialty
• Sports Medicine (Internal Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.