Individual provider Active NPI

John William Kennedy Jr., MD

  • Orthopaedic Surgery Physician
  • Springfield, MA
National Provider Identifier
1023645587
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
31144801 Issued in NY
Practice address
300 Birnie Ave Ste 201
Springfield, MA 01107-1121
Phone
(413) 785-4666
Fax
(413) 846-4756
NPI assigned
Mar 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 31144801 NY Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 1027798 MA

Addresses

Primary practice location

300 Birnie Ave Ste 201
Springfield, MA 01107-1121

Mailing address

300 Birnie Ave Ste 201
Springfield, MA 01107-1121

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
I20260522000094 MA Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 7416427281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

300 Birnie Ave
Suite 201
Springfield, MA 01107-1146

PO Box
Suite 393
Seekonk, MA 02771

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31144801NYMDOrthopaedic Surgery Physician
1027798MAMDSports Medicine (Orthopaedic Surgery) Physician

Organizations & group practices 1

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": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1023645587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BIRNIE AVE STE 201",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BIRNIE AVE STE 201",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071121",
            "telephone_number": "413-785-4666",
            "fax_number": "413-846-4756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "31144801",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MA",
            "license": "1027798",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.