Individual provider Active NPI

Eric Kenworthy, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1174537583
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
170513 Issued in NY
Practice address
359 Clinton St
Brooklyn, NY 11231-3701
Phone
(718) 875-3070
Fax
(718) 875-7864
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 170513 NY Primary

Addresses

Primary practice location

359 Clinton St
Brooklyn, NY 11231-3701

Mailing address

359 Clinton St
Brooklyn, NY 11231-3701
Phone (718) 875-3070

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
I20080505000010 NY Practitioner - Internal Medicine 3971682873 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

359 Clinton St
Brooklyn, NY 11231-3701
Phone (718) 875-3070

Hospital & facility affiliations

  • VNS of Ny Home Care Chha Home health agency, New York, NY, CCN 337008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
170513NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Be Well Primary Health Care Center, LLC CurrentSince Oct 24, 2016 Accepting new patients

Locations

3007 Farragut Rd
Brooklyn, NY 11210
Phone (347) 915-1177

Organizations & group practices 1

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 1

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1174537583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "359 CLINTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112313701",
            "telephone_number": "718-875-3070",
            "fax_number": "718-875-7864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 CLINTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112313701",
            "telephone_number": "718-875-3070",
            "fax_number": "718-875-7864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENWORTHY",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "170513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.