Kennedy Palwasha Fazli Daftani, M.D, MHSA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA09194600 Issued in NJ

Practice address

271 Grove Ave Ste a
Verona, NJ 07044-1731

Phone

(973) 239-2600

Fax

(833) 495-1921

NPI assigned

Jun 17, 2010

Last updated

Apr 17, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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 NJ

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

Specialty

Family Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Vanguard Medical Group PAGroup PAC ID 5092751842, 59 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Patient Care Home health agency, West Orange, NJ, CCN 317060
• Hackensack Meridian Mountainside Medical Hospital, Montclair, NJ, CCN 310054

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25493/brand/1/csg/1/fhir/r4
• Direct secure messaging: kennedy.daftani.1@25493.direct.athenahealth.com

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.

• Vanguard Medical Group, PA

  dba Town Medical Associates, P.A.

  • Family Medicine Physician
  • Verona, NJ
  • NPI 1073674412
  Medicare reassignment Care Compare group NPD
• Primary Care for the Homebound PA

  • Home Health Agency
  • Verona, NJ
  • NPI 1609206671

  Family Medicine

  NPD

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

• Montclair Hospital LLC

  dba HackensackUMC Mountainside

  • General Acute Care Hospital
  • Montclair, NJ
  • NPI 1982720249
  Care Compare affiliation
• Patient Care Medical Services, Inc.

  dba Patient Care

  • Home Health Agency
  • West Orange, NJ
  • NPI 1922089929
  Care Compare affiliation

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1043531726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 GROVE AVE STE E",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070441730",
            "telephone_number": "973-559-3700",
            "fax_number": "833-484-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 GROVE AVE STE A",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070441731",
            "telephone_number": "973-239-2600",
            "fax_number": "833-495-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAFTANI",
        "first_name": "KENNEDY",
        "middle_name": "PALWASHA FAZLI",
        "name_prefix": "Dr.",
        "credential": "M.D, MHSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA09194600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cornerstone Counseling Associates LLC
• Jennifer Crayner-Aryee
• Richard R. Cross, BCBA
• Brandon Cruz, PT, DPT
• Shannon Patricia Curtin, PT,DPT
• Mohammad Daoud Daftani, M.D
• Jane Ellen Daniel, RD
• Antonio A De la Cruz, MD
• Katherine Anne Decourcelle, PA-C
• Alison Del Duca, CCC-SLP

• Family Medicine Physician in Verona, NJ
• Providers in Verona, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.