Individual provider Active NPI

Kevin J McSherry, MD

  • Pediatrics Physician
  • Morristown, NJ
National Provider Identifier
1336145986
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA05487000 Issued in NJ
Practice address
100 Madison Ave.
Morristown Memorial Hospital - Dept of Emerg Medicine
Morristown, NJ 07960
Phone
(973) 971-6000
NPI assigned
Jun 28, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA05487000 NJ Primary

Addresses

Primary practice location

100 Madison Ave.
Morristown Memorial Hospital - Dept of Emerg Medicine
Morristown, NJ 07960

Mailing address

Morristown Memorial Hospital
100 Madison Ave.
Morristown, NJ 07962
Phone (973) 971-6000

Other identifiers 1

IdentifierTypeStateIssuer
0390500MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 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
I20050308000866 NY Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 1153375662 Reassigns benefits to 1 organization
I20070803000053 NJ Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 1153375662 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nyack Emergency Medical Association PLLC CurrentSince Sep 1, 2010 Accepting new patients
Morristown Emergency Medical Associates LLC CurrentSince Mar 1, 2012 Accepting new patients
Liberty Child and Adolescent Health Services Past Accepting new patients
Jersey City Medical Center Past Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients

Locations

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

160 N Midland Ave
Nyack, NY 10960
Phone (845) 348-2000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336145986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MORRISTOWN MEMORIAL HOSPITAL",
            "address_2": "100 MADISON AVE.",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "07962",
            "telephone_number": "973-971-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE.",
            "address_2": "MORRISTOWN MEMORIAL HOSPITAL - DEPT OF EMERG MEDICINE",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "07960",
            "telephone_number": "973-971-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCSHERRY",
        "first_name": "KEVIN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA05487000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0390500",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, NJ

Sources for this page

Verify at the official NPI Registry.