Individual provider Active NPI

Timothy John Kennedy, M.D.

  • Surgical Oncology Physician
  • New Brunswick, NJ
National Provider Identifier
1235394255
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
25MA09700900 Issued in NJ
Practice address
195 Little Albany St
Suite 560
New Brunswick, NJ 08901-1914
Phone
(732) 235-6572
NPI assigned
Jul 21, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA09700900 NJ
Surgical Oncology Physician 2086X0206X 239314 NY
Surgical Oncology Physician 2086X0206X 25MA09700900 NJ Primary

Addresses

Primary practice location

195 Little Albany St
Suite 560
New Brunswick, NJ 08901-1914

Mailing address

111 W 67TH St Apt 27F
New York, NY 10023-5957
Phone (646) 300-1745

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150917001570 NJ Practitioner - Surgical Oncology 0749344885 Reassigns benefits to 1 organization
I20250124001145 DC Practitioner - Surgical Oncology 0749344885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Georgetown University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

110 Irving St NW
Washington, DC 20010-3017
Phone (202) 877-7000

Hospital & facility affiliations

  • Medstar Georgetown University Hospital Hospital, Washington, DC, CCN 090004
  • Medstar Washington Hospital Center Hospital, Washington, DC, CCN 090011

Merit-based Incentive Payment System (MIPS)

Final score
88.4 of 100Reported as group
Quality
70.64
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09700900NJMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Primary Medicine Group Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Feb 1, 2021 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 17, 2024 Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Feb 1, 2021 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 17, 2024 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

3007 Tilden St NW
Ste 5N
Washington, DC 20008

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

195 Little Albany St
New Brunswick, NJ 08901
Phone (732) 235-2465

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

195 Little Albany St
Ste 560
New Brunswick, NJ 08901
Phone (732) 235-6572

125 Paterson St
Ste 5100
New Brunswick, NJ 08901
Phone (732) 235-7060

125 Paterson St
Ste 6100
New Brunswick, NJ 08901
Phone (732) 235-6561

1140 Route 72 W
Stafford Township, NJ 08050
Phone (609) 978-2194

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

Interoperability endpoints

  • Direct secure messaging: timothy.kennedy@cinj.rutgers.direct.varian.com
  • Direct secure messaging: tkennedy18272@epicdirect.rwjbh.org

Organizations & group practices 7

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 2

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": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1235394255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W 67TH ST APT 27F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100235957",
            "telephone_number": "646-300-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 LITTLE ALBANY ST",
            "address_2": "SUITE 560",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011914",
            "telephone_number": "732-235-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "TIMOTHY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-21",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA09700900",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NY",
            "license": "239314",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NJ",
            "license": "25MA09700900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.