Individual provider Active NPI

Patricia Kennery, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Williamsville, NY
National Provider Identifier
1295161016
Registry record updated Apr 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F342690 Issued in NY
Practice address
100 College Pkwy Ste 110
Williamsville, NY 14221-6885
Phone
(716) 276-2123
NPI assigned
Sep 25, 2013
Last updated
Apr 25, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 673309 NY
Family Nurse Practitioner 363LF0000X F342690 NY Primary

Addresses

Primary practice location

100 College Pkwy Ste 110
Williamsville, NY 14221-6885

Mailing address

100 College Pkwy Ste 110
Williamsville, NY 14221-6885
Phone (716) 631-8863

Other practice location 1

5842 Snyder Dr
Lockport, NY 14094-9497
Phone (716) 434-0195

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180605000832 NY Practitioner - Nurse Practitioner 3971868480 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rpci Oncology, PCGroup PAC ID 3870731029, 62 clinicians

Practice addresses (Care Compare)

199 Park Club LN
Williamsville, NY 14221-5269

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
673309NYMDRegistered Nurse
342690NYMDLicensed Practical Nurse
F342690NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Group of Western New York, LLP CurrentSince May 14, 2018 Accepting new patients
Rpci Oncology PC CurrentSince Aug 5, 2024 Accepting new patients
Saif Soniwala,M.D.,PC Current Accepting new patients

Locations

5842 Snyder Dr
Lockport, NY 14094
Phone (716) 434-0195

2699 Wehrle Dr
Williamsville, NY 14221
Phone (716) 631-8863

199 Park Club Ln
Ste 200
Williamsville, NY 14221
Phone (716) 634-3340

100 College Pkwy
Ste 110
Williamsville, NY 14221
Phone (716) 276-2123

Interoperability endpoints

  • Direct secure messaging: pkennery@breastcarewny.medentdirect.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1295161016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 COLLEGE PKWY STE 110",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216885",
            "telephone_number": "716-631-8863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COLLEGE PKWY STE 110",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216885",
            "telephone_number": "716-276-2123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5842 Snyder Dr",
            "address_purpose": "LOCATION",
            "city": "Lockport",
            "state": "NY",
            "postal_code": "140949497",
            "country_code": "US",
            "telephone_number": "716-434-0195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNERY",
        "first_name": "PATRICIA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-25",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "673309",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F342690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.