Individual provider Active NPI

Kathleen M Kenney-Riley, RNP

  • Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1225185051
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
380370 Issued in NY
Practice address
111 E 210TH St
MMC - Pediatric ER
Bronx, NY 10467-2401
Phone
(718) 741-2150
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 380370 NY Primary
Pediatric Nurse Practitioner 363LP0200X 12.008134 CT

Addresses

Primary practice location

111 E 210TH St
MMC - Pediatric ER
Bronx, NY 10467-2401

Mailing address

1 Landmark SQ
Apt # 613
Port Chester, NY 10573-3348
Phone (718) 741-2150

Other practice location 1

5 Perryridge Rd
Greenwich, CT 06830-4608
Phone (203) 863-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
380370NYMDNurse Practitioner
12.008134CTMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PM Pediatrics PC Past Accepting new patients
Montefiore Medical Center Past Accepting new patients
PM Pediatrics of Mamaroneck Past Accepting new patients
PM Pediatrics of Bayside PLLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1225185051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LANDMARK SQ",
            "address_2": "APT # 613",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105733348",
            "telephone_number": "718-741-2150",
            "fax_number": "718-741-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "address_2": "MMC - PEDIATRIC ER",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-741-2150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Perryridge Rd",
            "address_purpose": "LOCATION",
            "city": "Greenwich",
            "state": "CT",
            "postal_code": "068304608",
            "country_code": "US",
            "telephone_number": "203-863-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEY-RILEY",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "RNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "380370",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "12.008134",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.