Eileen A Keneck, MD

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

75852 Issued in MA

Practice address

840 Harrison Ave
Menino 1
Boston, MA 02118-2905

Phone

(617) 414-4991

Fax

(617) 414-4999

NPI assigned

Nov 30, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ekeneck10840@direct.bmc.masshiway.net

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.

• Child Health Foundation of Boston, Inc.

  • Pediatrics Physician
  • Boston, MA
  • NPI 1619969920
  Medicare reassignment NPD
• Reliant Medical Group, Inc

  • Family Medicine Physician
  • Worcester, MA
  • NPI 1720017528

  Pediatrics

  Medicare reassignment NPD
• Boston Medical Center Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1346218294
  NPD

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404345600000",
    "number": "1316921711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 HARRISON AVE",
            "address_2": "MENINO 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182905",
            "telephone_number": "617-414-4991",
            "fax_number": "617-414-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENECK",
        "first_name": "EILEEN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2014-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "75852",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "MA",
            "license": "75852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110051833A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth M Kendrick, LCSW
• Jessie Leigh Kendrick, PA-C
• Joshua Kendrick, PA-S
• Karla Kendrick, MD
• Lisa J Kendricken, RN
• Mara Kenger, M.D.
• Prachee Kishor Keni
• Sara Mae Kenimer
• Kaitlyn Kenjesky, PHARMD
• Kenmore Optical

• Pediatric Emergency Medicine (Pediatrics) Physician in Boston, MA
• Providers in Boston, MA by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.