Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Kenneth R. Selig, PA

Individual provider Basic Emergency Medical Technician · NPI 1174701007

Mr. Kenneth R. Selig, PA is a Physician Assistant in New York, New York. Graduated from University of Nebraska College of Medicine in 2010, 16 years ago. Practices with Northeast Medical Group Inc, a 1,360-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Connecticut and New York.

Years since qualifying
16
Trained at
University of Nebraska College of Medicine
Licensed in
CT, NY
In the registry since
2008
Specialties on file
3
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

462 1st Ave
New York, NY 10016-9196
Phone: (212) 562-6365
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 63 Dale Ave, Ossining, NY 10562-3559 — (646) 241-4497

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 011748 (NY)
Basic Emergency Medical Technician Taxonomy 146N00000X · Licence 320446 (NY)
Physician Assistant Taxonomy 363A00000X · Licence 002803 (CT)

Record details

NPI number1174701007
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 1, 2008
Last updated in NPPESMarch 17, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Graduated 2010 (16 years in practice)
Group practice Northeast Medical Group Inc — 1360 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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