Individual provider Active NPI

Michael Gerald Kennedy, MD

  • Orthopaedic Trauma Physician
  • Natick, MA
National Provider Identifier
1295767614
Registry record updated Dec 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
45134 Issued in MA
Practice address
6 Union St
Natick, MA 01760-4784
Phone
(508) 655-5115
Fax
(508) 650-9351
NPI assigned
Jul 7, 2006
Last updated
Dec 1, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Trauma Physician 207XX0801X 45134 MA Primary

Addresses

Primary practice location

6 Union St
Natick, MA 01760-4784

Mailing address

6 Union St
Natick, MA 01760-4784
Phone (508) 655-5115

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051019001019 MA Practitioner - Orthopedic Surgery 8224054168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6 Union St
Natic, MA 01760-4784
Phone (508) 655-5115

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michael G Kennedy MD PC CurrentSince Oct 1, 1980 Accepting new patients
Boston Advanced Medicine Inc Past Accepting new patients

Locations

6 Union St
Natick, MA 01760
Phone (508) 655-5115

Organizations & group practices 2

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 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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291161600000",
    "number": "1295767614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 UNION ST",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017604784",
            "telephone_number": "508-655-5115",
            "fax_number": "508-650-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 UNION ST",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017604784",
            "telephone_number": "508-655-5115",
            "fax_number": "508-650-9351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MICHAEL",
        "middle_name": "GERALD",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2010-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "MA",
            "license": "45134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Natick, MA

Sources for this page

Verify at the official NPI Registry.