Kennedy Ophthalmic Associates PLLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

0061131 Issued in NY

Legal business name

KENNEDY OPHTHALMIC ASSOCIATES PLLC

Practice address

1675 Providence Ave
Schenectady, NY 12309

Phone

(518) 377-2144

Fax

(518) 377-0436

NPI assigned

May 7, 2007

Organization subpart

No

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

Authorized official

Name

Robert J Kennedy, MDNPI 1801817424

Title

Physician

Phone

(518) 377-3439

Specialties & licenses 1

Addresses

Other names 1

• Kennedy Optical Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Kennedy Ophthalmology Associates PLLC

  • Ophthalmology Physician
  • Schenectady, NY
  • NPI 1215150552

  6002709557

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Kennedy Ophthalmology Assoc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kennedy Ophthalmology Associates PLLC

  • Ophthalmology Physician
  • Schenectady, NY
  • NPI 1215150552
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert J Kennedy, MD

  • Ophthalmology Physician
  • Schenectady, NY
  • NPI 1801817424
  NPD (past) Authorized official
• John J Kennedy Jr., MD

  • Ophthalmology Physician
  • Schenectady, NY
  • NPI 1356382378
  NPD (past)
• Glenn William Thompson, M.D.

  • Ophthalmology Physician
  • Schenectady, NY
  • NPI 1689880163
  NPD (past)
• Erica Lynn Archer, M.D.

  • Ophthalmology Physician
  • Ann Arbor, MI
  • NPI 1518227743
  NPD (past)

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1083826374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 PROVIDENCE AVENUE",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "12309",
            "telephone_number": "518-377-2144",
            "fax_number": "518-377-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 PROVIDENCE AVE",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "12309",
            "telephone_number": "518-377-2144",
            "fax_number": "518-377-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY OPHTHALMIC ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "518-377-3439",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NY",
            "license": "0061131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kennedy Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alethea Nadine Kelly, MS CCC-SLP
• Leslie L Kelly, RD
• Samantha Jean Kelly, PMHNP
• Jonathan R Kemp, M.D.
• Mary Margaret Keniry
• Kennedy Ophthalmology Associates PLLC
• Amy Rebecca Kennedy, RD
• Ashley E G Kennedy, FNP
• John J Kennedy Jr., MD
• Joslin Rae Kennedy, LCSW

• Eyewear Supplier in Schenectady, NY
• Providers in Schenectady, NY by specialty
• Eyewear Supplier in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.