Individual provider Active NPI

Brian A. Kenny, M.D.

  • Internal Medicine Physician
  • Raynham, MA
National Provider Identifier
1023007358
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
82051 Issued in MA
Practice address
546 South St E
Raynham, MA 02767-1079
Phone
(508) 821-5700
Fax
(617) 479-0857
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 82051 MA Primary

Addresses

Primary practice location

546 South St E
Raynham, MA 02767-1079

Mailing address

PO Box 2153 Dept 40338
Birmingham, AL 35287-9386
Phone (423) 310-1642

Other identifiers 1

IdentifierTypeStateIssuer
3147711MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041104000808 MA Practitioner - Internal Medicine 8123081809 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Onsite, Inc Internal Medicine CurrentSince Sep 1, 2015 Accepting new patients
Steward Medical Group, Inc CurrentSince Oct 1, 2012 Accepting new patients
Steward Medical Group, Inc CurrentSince Oct 1, 2012 Accepting new patients
Raynham Medical Investors LLC Past Accepting new patients
Caritas Medical Group, Inc. Past Accepting new patients
Nova Psychiatric Services, PC PastSince Apr 3, 2022 Accepting new patients
Medical Care of Boston Management Corporation Internal Medicine Past Accepting new patients
Community Physicians Associates, Inc. Past Accepting new patients
Carney Medical Group Past Accepting new patients
Community Physicians Associates, Inc. Internal Medicine Past Accepting new patients
Southeast Anesthesia Assoc Past Accepting new patients
Boston Medical Group, PC Past Accepting new patients

Locations

969 Park St
Attleboro, MA 02703
Phone (508) 222-4182

11 Nevins St
Brighton, MA 02135
Phone (617) 562-2782

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

2110 Dorchester Ave
Ste 310
Dorchestr Ctr, MA 02124
Phone (617) 296-0720

2100 Dorchester Ave
Dorchestr Ctr, MA 02124
Phone (617) 506-2222

2100 Dorchester Ave
Fl 7
Dorchestr Ctr, MA 02124
Phone (617) 296-4012

1261 Furnace Brook Pkwy
Ste 22
Quincy, MA 02169
Phone (617) 302-2481

700 Congress St
Ste 301D
Quincy, MA 02169
Phone (617) 786-8700

546 South St E
Raynham, MA 02767
Phone (508) 821-5700

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1023007358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2153 DEPT 40338",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352879386",
            "telephone_number": "423-310-1642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 SOUTH ST E",
            "city": "RAYNHAM",
            "state": "MA",
            "postal_code": "027671079",
            "telephone_number": "508-821-5700",
            "fax_number": "617-479-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNY",
        "first_name": "BRIAN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "82051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3147711",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raynham, MA

Sources for this page

Verify at the official NPI Registry.