MS. KELLY ANN GANNON OTR/L
NPI 1396975140
Occupational Therapist in New Hyde Park, NY

Active since July 14, 2009Accepts Medicare Assignment
501 S 14TH ST, NEW HYDE PARK, NY 11040(516) 328-3216 Get Directions Write a Review

NPPES record last updated: July 14, 2009. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ms. Kelly Ann Gannon Otr/l NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. KELLY ANN GANNON OTR/L (NPI 1396975140) is an individual occupational therapist in New Hyde Park, New York, licensed in New York (012458-1) and active in the NPI registry since July 2009. She is a graduate of Other (2002).

NPPES Registry Identity

NPI1396975140
Entity TypeIndividualFemale
Primary Taxonomy225X00000X
Provider Legal NameMS. KELLY ANN GANNONCredential: OTR/L
Location Address501 S 14TH STNew Hyde Park, NY 11040-5576
Mailing Address501 S 14th StNew Hyde Park, NY 11040-5576 · (516) 328-3216
Sole ProprietorYes
Medical School CMSOtherGraduated 2002
Enumeration DateJuly 14, 2009
✔ NPI 1396975140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225X00000X
License✔ Licensed in NY · 012458-1
Definition
An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
501 S 14TH ST, New Hyde Park, NY 11040

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Kelly Ann Gannon Otr/l is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820316946
PECOS Enrollment IDI20150421001003

Medicare Billing Reassignment

Medicare enrollment records show Kelly Gannon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Physical Therapy
1461 LAKELAND AVE, SUITE 12
Bohemia, NY 11716
  • Reassigned Medicare billing, New York enrollment
  • 2 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Gannon's NPI number?

The NPI number for Kelly Gannon is 1396975140. It was assigned to this individual provider in the NPPES registry on July 14, 2009.

Where is Kelly Gannon located?

Kelly Gannon practices at 501 S 14th St, New Hyde Park, NY 11040. The listed phone number is (516) 328-3216.

What is Kelly Gannon's specialty?

The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.

Is Kelly Gannon enrolled in Medicare?

Yes. Kelly Gannon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kelly Gannon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Gannon reassigns Medicare benefits to Islander Physical And Occupational Therapy Services, PLLC (Bohemia, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Gannon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kelly Gannon was last updated on July 14, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.