Individual provider Active NPI

Kristin S. Kenney, O.D.

  • Optometrist
  • Plymouth, MA
National Provider Identifier
1154430288
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4352 Issued in MA
Practice address
45 Resnik Rd
Suite 301
Plymouth, MA 02360-4844
Phone
(508) 747-4748
Fax
(508) 747-0124
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4352 MA Primary

Addresses

Primary practice location

45 Resnik Rd
Suite 301
Plymouth, MA 02360-4844

Mailing address

45 Resnik Rd
Suite 301
Plymouth, MA 02360-4844
Phone (508) 747-4748

Other identifiers 1

IdentifierTypeStateIssuer
0702790MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040830000613 MA Practitioner - Optometry 3870568280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Eye SurgeonsGroup PAC ID 7012982432, 4 clinicians

Practice addresses (Care Compare)

45 Resnik Rd
Suite 301
Plymouth, MA 02360-4883
Phone 508747474824

Merit-based Incentive Payment System (MIPS)

Final score
89.63 of 100Reported as group
Quality
89.25
Improvement activities
40
Cost
79.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Eye Surgeons CurrentSince Jul 1, 2004 Accepting new patients
Associated Eye Surgeons PastSince Jul 1, 2004 Accepting new patients

Locations

45 Resnik Rd
Plymouth, MA 02360
Phone (508) 746-0754

3 Village Grn N
Ste 321
Plymouth, MA 02360
Phone (508) 224-2224

45 Resnik Rd
Ste 301
Plymouth, MA 02360
Phone (508) 747-4748

441 Route 130
Ste 10
Sandwich, MA 02563
Phone (508) 747-4748

Interoperability endpoints

  • Direct secure messaging: kkenney@aes.emadirect.md

Organizations & group practices 2

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.

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": "1358467200000",
    "number": "1154430288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 RESNIK RD",
            "address_2": "SUITE 301",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604844",
            "telephone_number": "508-747-4748",
            "fax_number": "508-747-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 RESNIK RD",
            "address_2": "SUITE 301",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604844",
            "telephone_number": "508-747-4748",
            "fax_number": "508-747-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "KRISTIN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0702790",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.