Jacqueline Taylor Kenney, OD

Primary specialty

Pediatric OptometristTaxonomy code 152WP0200X

License

OPT5618 Issued in MA

Practice address

77 Herrick St Ste 102
Beverly, MA 01915-2734

Phone

(978) 338-4321

Fax

(978) 927-1010

NPI assigned

May 15, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

New England College of Optometry, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkenney25631@direct.bostonchildrens.org

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.

• Specialized Pediatric Eye Care, Inc

  • Ophthalmology Physician
  • Beverly, MA
  • NPI 1457733917
  Medicare reassignment NPD

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1033809884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 HERRICK ST STE 102",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019152734",
            "telephone_number": "978-338-4321",
            "fax_number": "978-927-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 HERRICK ST STE 102",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019152734",
            "telephone_number": "978-338-4321",
            "fax_number": "978-927-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "JACQUELINE",
        "middle_name": "TAYLOR",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "OPT5618",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MA",
            "license": "OPT5618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Moreau Kemp, MD, MS
• Nathan Gordon Kenison, LMT
• Kathryn Turner Keniston
• Beth Benatti Kennedy, M.S., CAGS
• Rachel McCain Kennedy, DNAP, CRNA
• Caitlin Kenny, LICSW
• Joi Ellen Kenny, FAMILY PARTNER
• Patricia Anne Kenny, RN PCNS
• Alexandra Keresztes
• Kettle Cove Counseling, LLC

• Pediatric Optometrist in Beverly, MA
• Providers in Beverly, MA by specialty
• Pediatric Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.