Miriam Kennelly, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD61057916 Issued in WA

Practice address

1101 Madison St Ste 301
Seattle, WA 98104-3599

Phone

(206) 505-1300

NPI assigned

Mar 31, 2017

Sex

Female

Sole proprietor

Yes

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 WA

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

Internal Medicine

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pacmed ClinicsGroup PAC ID 2466350657, 211 clinicians

Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians

Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Swedish Medical Center Hospital, Seattle, WA, CCN 500027

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pacmed Clinics

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1013061217

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248
  Care Compare group
• Pacmed Clinics

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1720023641
  NPD
• Pacmed Clinics

  • Multi-Specialty Clinic/Center
  • Puyallup, WA
  • NPI 1841550530
  NPD

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

• Swedish Health Services

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1306992151
  Care Compare affiliation

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

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1114459872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST STE 301",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST STE 301",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043599",
            "telephone_number": "206-505-1300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "757 Westwood Plz Ste 7236",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900954954",
            "country_code": "US",
            "telephone_number": "310-267-7849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNELLY",
        "first_name": "MIRIAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-31",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61057916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simran Kennedy, CRNA
• Stephen Alan Kennedy, M.D., FRCSC
• Winter Kennedy, LMP
• Nathan Paul Kennel, D.P.T.
• Jennifer Christine Kennelly, LMHC, CDP
• Carrie Kenner, CD(DONA)
• Tess Kenner
• Kenneth N. Asher, PH.D., P.S.
• Lauren Elizabeth Kenney-Crowell, ARNP
• Anne Kenney

• Internal Medicine Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.