Active NPI
Kenneth J. Knowles II, MD
- Emergency Medicine Physician
- Worcester, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 269932
- Practice address
- 55 Lake Ave N
Department of Emergency Medicine
Worcester, MA 01655-0002 - Phone
- (508) 421-1400
- Fax
- (508) 421-1490
- NPI assigned
- Mar 24, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 269932 | MA | Primary |
Addresses
Primary practice location
55 Lake Ave N
Department of Emergency Medicine
Worcester, MA 01655-0002
Mailing address
9 Tinkham Glen
Wilbraham, MA 01095
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110111119A | Medicaid | MA |
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: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- New York Medical College, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
759 Chestnut St
Springfield, MA 01107-1619
Phone (413) 794-8121
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 269932 | MA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baystate Franklin Medical Center | Current | Accepting new patients | |
| Baystate Wing Hospital Corporation | Current | Accepting new patients | |
| Baystate Medical Practices, Inc | Current | Accepting new patients | |
| Baystate Wing Hospital Corporation | Current | Accepting new patients |
Locations
164 High St
Greenfield, MA 01301
Phone (413) 772-0211
40 Wright St
Palmer, MA 01069
Phone (413) 284-5210
759 Chestnut St
Springfield, MA 01107
Phone (413) 794-6297
280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385
759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233
55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862
Interoperability endpoints
- kenneth.knowles.1@13869.direct.athenahealth.com
Organizations & group practices 4
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.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Springfield, MA
- NPI 1548205909
-
- General Acute Care Hospital
- Greenfield, MA
- NPI 1508867391
-
- General Acute Care Hospital
- Palmer, MA
- NPI 1962410233
-
- Psychiatric Hospital Unit
- Palmer, MA
- NPI 1992880736
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Springfield, MA
- NPI 1487655064
-
- General Acute Care Hospital
- Palmer, MA
- NPI 1962410233
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517875200000",
"number": "1184041568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 TINKHAM GLEN",
"city": "WILBRAHAM",
"state": "MA",
"postal_code": "01095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 LAKE AVE N",
"address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016550002",
"telephone_number": "508-421-1400",
"fax_number": "508-421-1490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNOWLES",
"first_name": "KENNETH",
"middle_name": "J.",
"name_suffix": "II",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-24",
"last_updated": "2018-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MA",
"license": "269932",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110111119A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; 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.