Individual provider Active NPI

Kendra Bergeron

  • Driving and Community Mobility Occupational Therapist
  • Clinton, NY
National Provider Identifier
1932066404
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Driving and Community Mobility Occupational TherapistTaxonomy code 225XR0403X
License
030785 Issued in NY
Practice address
19 Robinson Rd
Clinton, NY 13323-1418
Phone
(315) 853-6090
NPI assigned
Jan 7, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driving and Community Mobility Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XR0403X 030785 NY Primary

Addresses

Primary practice location

19 Robinson Rd
Clinton, NY 13323-1418

Mailing address

2522 Van Dyke Ave
Schenectady, NY 12306-3834

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
030785NYMDDriving and Community Mobility Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1767744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1932066404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2522 VAN DYKE AVE",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123063834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 ROBINSON RD",
            "city": "CLINTON",
            "state": "NY",
            "postal_code": "133231418",
            "telephone_number": "315-853-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "KENDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-07",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XR0403X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Driving and Community Mobility",
            "state": "NY",
            "license": "030785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.