Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Kelly Ann Gannon, OTR/L

Individual provider Occupational Therapist · NPI 1396975140

MS. Kelly Ann Gannon, OTR/L is an Occupational Therapist in Private Practice in New Hyde Park, New York. Qualified in 2002, 24 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in New York.

Years since qualifying
24
Licensed in
NY
In the registry since
2009
What do these letters mean?
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

501 S 14th St
New Hyde Park, NY 11040-5576
Phone: (516) 328-3216
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 012458-1 (NY)

Record details

NPI number1396975140
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTR/L
Sole proprietorYes
NPI enumeratedJuly 14, 2009
Last updated in NPPESJuly 14, 2009

Medicare enrollment

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

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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