Individual provider Active NPI

Barbara A. Kilkenny, D.P.M.

  • Podiatrist
  • Southbury, CT
National Provider Identifier
1356336218
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
CT000528 Issued in CT
Practice address
2 Pomperaug Office Park
Suite 106
Southbury, CT 06488-2288
Phone
(203) 264-0800
Fax
(203) 264-2657
NPI assigned
Sep 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X CT000528 CT Primary

Addresses

Primary practice location

2 Pomperaug Office Park
Suite 106
Southbury, CT 06488-2288

Mailing address

2 Pomperaug Office Park
Suite 106
Southbury, CT 06488-2288
Phone (203) 264-0800

Other identifiers 11

IdentifierTypeStateIssuer
2V4886OtherHEALTHNET
790153OtherCOCONNECTICARE
004100450MedicaidCT
606567OtherAETNA HEALTH PLAN
061390153OtherCTCIGNA
030000528CT05OtherCOANTHEM BC/BS
P3239125OtherCTOXFORD
061390153OtherCTUNITED HEALTHCARE
004250106OtherCTCT MEDICAL ASSISTANCE PRO
5342810001OtherCODEMERC REGION A
P00146982OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040923000246 CT Practitioner - Podiatry 8224006739 Receives reassigned benefits from 1 practitioner
Practice locations: Southbury, CT
O20100930070667 CT DME Supplier - Physician - Podiatry 1759359219 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Southbury, CT

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 Pomperaug Office Park
Suite 106
Southbury, CT 06488-2288

2 Pomperaug Office Park
Suite 106
Southbury, CT 06488-2290
Phone (203) 264-0080

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue11
Removal of skin lesions19
Removal of nail tissue1178
Removal or shaving of skin growth329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CT000528CTMDPodiatrist
000528CTMDPhysical Therapy Assistant

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1356336218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 POMPERAUG OFFICE PARK",
            "address_2": "SUITE 106",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064882288",
            "telephone_number": "203-264-0800",
            "fax_number": "203-264-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 POMPERAUG OFFICE PARK",
            "address_2": "SUITE 106",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064882288",
            "telephone_number": "203-264-0800",
            "fax_number": "203-264-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILKENNY",
        "first_name": "BARBARA",
        "middle_name": "A.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-16",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CT",
            "license": "CT000528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2V4886",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "790153",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004100450",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTH PLAN",
            "identifier": "606567",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "061390153",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "030000528CT05",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3239125",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "061390153",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT MEDICAL ASSISTANCE PRO",
            "identifier": "004250106",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEMERC REGION A",
            "identifier": "5342810001",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00146982",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbury, CT

Sources for this page

Verify at the official NPI Registry.