MRS. TINA MARIE MCKENNON CRNP
NPI 1992163422
Nurse Practitioner - Adult Health in Philadelphia, PA

Active since January 28, 2016PECOS EnrolledAccepts Medicare Assignment
51 N 39TH STREET, CUPP BUILDING 1ST FLOOR, PHILADELPHIA, PA 19104(215) 662-9801(215) 243-3249 Get Directions Write a Review

NPPES record last updated: June 29, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Oct 18, 2016, Jan 28, 2016 (2 updates tracked since 2016).

About Mrs. Tina Marie Mckennon Crnp NPPES

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

MRS. TINA MARIE MCKENNON CRNP (NPI 1992163422) is an individual adult health provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (SP015746) and active in the NPI registry since January 2016. She is enrolled in Medicare PECOS, is affiliated with West Jersey Hospital, and maintains a secondary practice location in Cherry Hill.

NPPES Registry Identity

NPI1992163422
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameMRS. TINA MARIE MCKENNONCredential: CRNP
Location Address51 N 39TH STREET, CUPP BUILDING 1ST FLOORPhiladelphia, PA 19104-2640
Mailing Address51 N 39th Street, Cupp Building 1st FloorPhiladelphia, PA 19104-2640 · (215) 662-9801 · Fax (215) 243-3249
Fax(215) 243-3249
Sole ProprietorNo
Medical School CMSJefferson Medical College Of Thomas Jefferson UniversityGraduated 2013
Enumeration DateJanuary 28, 2016
Last NPPES UpdateJune 29, 20222 updates tracked since enumeration
NPPES CertifiedJune 21, 2022
NPI 1992163422 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
Licenses Licensed in PA · SP015746 Licensed in PA · A0915003 Licensed in NJ · 26NJ01153900
51 N 39TH STREET, Philadelphia, PA 19104

Secondary Practice Location 1

Location 11865 Route 70 East, STE 220Cherry Hill, NJ 08003-2013 · Phone (856) 429-1519 · Fax (856) 427-0250

Other Identifiers 1

Medicaid103155510PA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mrs. Tina Marie Mckennon Crnp 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 ID6305135088
PECOS Enrollment IDI20210803003473
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
588 services217 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

West Jersey Hospital

Acute Care Hospitals · Voorhees, NJ
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310022
Location100 Bowman DriveVoorhees, NJ 08043 · Camden County
Emergency services Birthing friendly

Penn Presbyterian Medical Center

Acute Care Hospitals · Philadelphia, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390223
Location51 North 39th StreetPhiladelphia, PA 19104 · Philadelphia County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$92.69 typical visit price
range $59.88 – $180.99
Typical copayment $23.17 (range $14.97 – $45.24)
Most-billed visit code 99203
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Capecitabine, oral, 500 mg J8521
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier15 claims1,050 services$0.72 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
51 N 39TH STREET, PPMC, DEPARTMENT OF MEDICINE
PHILADELPHIA, PA 19104
Emergency Medicine
51 N 39TH STREET
PHILADELPHIA, PA 19104
Emergency Medicine
51 N 39TH STREET
PHILADELPHIA, PA 19104
Ophthalmology
51 N 39TH STREET, SCHEIE EYE INSTITUTE
PHILADELPHIA, PA 19104
Ophthalmology
51 N 39TH STREET, SCHEIE EYE INSTITUTE
PHILADELPHIA, PA 19104
Emergency Medicine
51 N 39TH STREET, DIVISION OF CLINICAL INFORMATICS (PEDIATRICS)
PHILADELPHIA, PA 19104
Pharmacy (Specialty Pharmacy)
51 N 39TH STREET, MUTCH BUILDING-OUTPATIENT PHARMACY
PHILADELPHIA, PA 19104
Emergency Medicine
51 N 39TH STREET
PHILADELPHIA, PA 19104

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 Tina Mckennon's NPI number?

The NPI number for Tina Mckennon is 1992163422. It was assigned to this individual provider in the NPPES registry on January 28, 2016.

Where is Tina Mckennon located?

Tina Mckennon practices at 51 N 39th Street Cupp Building 1st Floor, Philadelphia, PA 19104. The listed phone number is (215) 662-9801.

What is Tina Mckennon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Tina Mckennon enrolled in Medicare?

Yes. Tina Mckennon 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.

Is Tina Mckennon affiliated with any hospitals?

According to CMS data, Tina Mckennon is affiliated with West Jersey Hospital and Penn Presbyterian Medical Center.

When was this NPI record last updated?

The NPPES record for Tina Mckennon was last updated on June 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.