Individual provider Active NPI

Julia Anne Kenniston, MD

  • Orthopaedic Hand Surgery Physician
  • Plymouth, MA
National Provider Identifier
1043370604
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
247594 Issued in MA
Practice address
41 Resnik Rd
Plymouth, MA 02360-4842
Phone
(781) 934-2400
Fax
(508) 746-3930
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MT185924 PA
Orthopaedic Hand Surgery Physician 207XS0106X 13225 RI
Orthopaedic Hand Surgery Physician 207XS0106X 247594 MA Primary

Addresses

Primary practice location

41 Resnik Rd
Plymouth, MA 02360-4842

Mailing address

95 Tremont St
Suite One
Duxbury, MA 02332-4738
Phone (781) 934-2400

Other practice location 1

290 Route 130
Sandwich, MA 02563-2366
Phone (781) 934-2400

Other practice location 2

95 Tremont St Ste 1
Duxbury, MA 02332-4738
Phone (781) 934-2400

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
I20110915000594 MA Practitioner - Orthopedic SurgeryPractitioner - Hand Surgery 2567657109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Hand Surgery
Education
Tufts University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plymouth Bay Orthopedic Associates IncGroup PAC ID 3375448335, 31 clinicians

Practice addresses (Care Compare)

290 Route 130
Sandwich, MA 02563-2366
Phone 78193424001204

41 Resnik Rd
Plymouth, MA 02360-4842

41 Resnik Rd
Plymouth, MA 02360-5721
Phone 78193424001204

95 Tremont St
Suite 1
Duxbury, MA 02332-4738
Phone 78193424001204

Hospital & facility affiliations

  • Bayada Home Health Care Inc Home health agency, Plymouth, MA, CCN 227537
  • Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060
  • Cape Cod Hospital Hospital, Hyannis, MA, CCN 220012
  • Falmouth Hospital Hospital, Falmouth, MA, CCN 220135
  • Spaulding Rehabilitation Hospital - Cape Cod Inpatient rehabilitation facility, East Sandwich, MA, CCN 223032

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT185924PAMDOrthopaedic Surgery Physician
13225RIMDOrthopaedic Hand Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Plymouth Bay Orthopedic Associates Inc. Orthopaedic Surgery CurrentSince Sep 1, 2011 Accepting new patients

Locations

95 Tremont St
Ste 1
Duxbury, MA 02332
Phone (781) 934-2400

41 Resnik Rd
Plymouth, MA 02360
Phone (781) 934-2400

290 Route 130
Sandwich, MA 02563
Phone (508) 833-2255

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CEIGAA/Endpoint/CEIGAA
  • Direct secure messaging: jkenniston252997@direct.bilh.masshiway.net

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Beth Israel Deaconess Hospital Plymouth IncPlymouth, MA, CCN 220060 Hospital Corporate Director Sep 19, 2023
Beth Israel Deaconess Hospital Plymouth IncPlymouth, MA, CCN 22S060 Hospital Corporate Director Sep 19, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1043370604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 TREMONT ST",
            "address_2": "SUITE ONE",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "023324738",
            "telephone_number": "781-934-2400",
            "fax_number": "781-934-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 RESNIK RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604842",
            "telephone_number": "781-934-2400",
            "fax_number": "508-746-3930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "290 Route 130",
            "address_purpose": "LOCATION",
            "city": "Sandwich",
            "state": "MA",
            "postal_code": "025632366",
            "country_code": "US",
            "telephone_number": "781-934-2400",
            "fax_number": "508-746-3930",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "95 Tremont St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Duxbury",
            "state": "MA",
            "postal_code": "023324738",
            "country_code": "US",
            "telephone_number": "781-934-2400",
            "fax_number": "508-746-3930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNISTON",
        "first_name": "JULIA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MT185924",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "RI",
            "license": "13225",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "MA",
            "license": "247594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.