Individual provider Active NPI

Angela Denise Kerr, MD

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1053421412
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
165697 Issued in NY
Practice address
240 Willoughby St
Brooklyn, NY 11201-5465
Phone
(718) 250-8318
Fax
(718) 797-5495
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 165697 NY Primary
Specialist 174400000X

Addresses

Primary practice location

240 Willoughby St
Brooklyn, NY 11201-5465

Mailing address

240 Willoughby St
3A
Brooklyn, NY 11201-5465
Phone (718) 250-8318

Other identifiers 1

IdentifierTypeStateIssuer
01031209MedicaidNY

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110607000360 NY Practitioner - Obstetrics/Gynecology 3577740208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of New York Downstate Medical Center, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amboy Medical Practice PCGroup PAC ID 2860538170, 171 clinicians

Practice addresses (Care Compare)

355 Bard Ave
Staten Island, NY 10310-1664

4434 Amboy Rd
Staten Island, NY 10312-3845
Phone (718) 984-9658

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
71.48 of 100Reported as apm
Quality
82.91
Promoting interoperability
5.67
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
165697NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Amboy Medical Practice PC CurrentSince Oct 1, 2019 Accepting new patients
Amboy Medical Practice PC CurrentSince Oct 1, 2019 Accepting new patients
Richmond Medical Center Past Accepting new patients
TBHC Medical Services PC Past Accepting new patients

Locations

660 92nd St
#2
Brooklyn, NY 11228

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: angela.kerr.1@19656.direct.athenahealth.com

Organizations & group practices 4

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 2

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375228800000",
    "number": "1053421412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 WILLOUGHBY ST",
            "address_2": "3A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015465",
            "telephone_number": "718-250-8318",
            "fax_number": "718-797-5495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 WILLOUGHBY ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015465",
            "telephone_number": "718-250-8318",
            "fax_number": "718-797-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "ANGELA",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "165697",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01031209",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.