Kevin Hennessy, NURSE PRACTITIONER

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F304561-1 Issued in NY

Practice address

701 Seneca St Ste 646C
Buffalo, NY 14210-1351

Phone

(716) 995-4450

NPI assigned

Jan 24, 2007

Last updated

Oct 25, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Family Choice of New York Medical PC

  • General Practice Physician
  • Depew, NY
  • NPI 1720312754
  Medicare reassignment NPD

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1023163813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 LOVERING AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142161846",
            "telephone_number": "716-871-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SENECA ST STE 646C",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142101351",
            "telephone_number": "716-995-4450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3332 WALDEN AVE",
            "address_2": "STE 110",
            "address_purpose": "LOCATION",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "140432400",
            "country_code": "US",
            "telephone_number": "716-668-7051",
            "fax_number": "716-668-7069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNESSY",
        "first_name": "KEVIN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F304561-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dane Hendry, DDS
• Carla R Henke, MD
• Jewell Ann Henley, MD
• Kathleen Lynn Henneberger, D.C.
• Emily C Hennessy, RPA-C
• Finn Hennig, MD
• Paul Joseph Hennigan, MSW
• Derrell Hennings
• Jamar Lamont Hennings
• Mark W Hennon, MD

• Adult Health Nurse Practitioner in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.