Timothy H Kenefick, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

028872 Issued in CT

Practice address

126 Morgan St
Stamford, CT 06905-5431

Phone

(203) 327-1055

Fax

(203) 323-6177

NPI assigned

Aug 3, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: tkenefick24363@stamfordhealth.direct-ci.com

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397174400000",
    "number": "1063413854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 MORGAN ST.",
            "address_2": "THE PEDIATRIC CENTER",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055431",
            "telephone_number": "203-327-1055",
            "fax_number": "203-323-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 MORGAN ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055431",
            "telephone_number": "203-327-1055",
            "fax_number": "203-323-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENEFICK",
        "first_name": "TIMOTHY",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2014-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "028872",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "163113",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001288720",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Stamford, CT
• Providers in Stamford, CT by specialty
• Pediatrics Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.