John J Kennedy Jr., MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

1390921 Issued in NY

Practice address

1675 Providence Ave
Schenectady, NY 12309

Phone

(518) 377-3439

Fax

(518) 377-0436

NPI assigned

Jun 9, 2006

Sex

Male

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 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Kennedy Ophthalmology Associates PLLC

  • Ophthalmology Physician
  • Schenectady, NY
  • NPI 1215150552
  Medicare reassignment NPD Authorized official
• Kennedy Ophthalmic Associates PLLC

  dba Kennedy Optical

  • Eyewear Supplier
  • Schenectady, NY
  • NPI 1083826374

  Ophthalmology

  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1356382378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 PROVIDENCE AVE",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "12309",
            "telephone_number": "518-377-3439",
            "fax_number": "518-377-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 PROVIDENCE AVE",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "12309",
            "telephone_number": "518-377-3439",
            "fax_number": "518-377-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "1390921",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0021006",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10001040",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00747291",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "17108",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Margaret Keniry
• Kennedy Ophthalmic Associates PLLC (Kennedy Optical)
• Kennedy Ophthalmology Associates PLLC
• Amy Rebecca Kennedy, RD
• Ashley E G Kennedy, FNP
• Joslin Rae Kennedy, LCSW
• Robert J Kennedy, MD
• Kenneth D Schwartz DDS PC
• Kenneth March, DPM PLLC
• Jolene M. Kent Stanley, LCSW-R

• Ophthalmology Physician in Schenectady, NY
• Providers in Schenectady, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; 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.