NPIMap

Individual provider Active NPI

Kimberly M Hadian, MD

  • Family Medicine Physician
  • Canton, NY
National Provider Identifier
1235545963
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
290105-1 Issued in NY
Practice address
21 Court St
Canton, NY 13617-1136
Phone
(646) 352-3216
NPI assigned
Jul 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 290105-1 NY Primary

Addresses

Primary practice location

21 Court St
Canton, NY 13617-1136

Mailing address

24 Woods Dr
Canton, NY 13617-1061
Phone (646) 352-3216

Other names 1

  • Kimbery McKenney Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171019000789 NY Practitioner - Family Practice 6507132545 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gouverneur HospitalGroup PAC ID 9931336724, 31 clinicians
Canton-Potsdam HospitalGroup PAC ID 6204827280, 243 clinicians

Practice addresses (Care Compare)

2924 County Route 17
De Kalb Junction, NY 13630-3136
Phone (315) 347-3830

77 W Barney St
CPH Specialty Suites at GVNR
Governed, NY 13642-1040
Phone (315) 287-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.56 of 100Reported as apm
Quality
87.76
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
290105-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gouverneur Hospital CurrentSince Jun 1, 2020 Accepting new patients
Canton-Potsdam Hospital CurrentSince Jun 1, 2020 Accepting new patients
Canton-Potsdam Hospital CurrentSince Jun 1, 2020 Accepting new patients
Gouverneur Hospital CurrentSince Jun 1, 2020 Accepting new patients
Canton Potsdam Hospital Past Accepting new patients

Locations

80 E Main St
Canton, NY 13617
Phone (315) 261-6034

2924 County Route 17
De Kalb Junction, NY 13630
Phone (315) 347-3830

77 W Barney St
Gouverneur, NY 13642
Phone (315) 287-1000

50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034

201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102

Interoperability endpoints

  • Direct secure messaging: khadian325808@direct.rochesterregional.org

Organizations & group practices 5

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 6

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": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1235545963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 WOODS DR",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171061",
            "telephone_number": "646-352-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 COURT ST",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171136",
            "telephone_number": "646-352-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADIAN",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-02",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "290105-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERY",
            "last_name": "MCKENNEY",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Canton, NY

Sources for this page

Verify at the official NPI Registry.