Individual provider Active NPI

Kenneth F Hardy Jr., MD

  • Dermatology Physician
  • Morgantown, WV
National Provider Identifier
1356415533
Registry record updated Apr 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
17968 Issued in WV
Practice address
1311 Pineview Drive
Suite 200
Morgantown, WV 26505
Phone
(304) 598-7546
Fax
(304) 225-7551
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 17968 WV Primary

Addresses

Primary practice location

1311 Pineview Drive
Suite 200
Morgantown, WV 26505

Mailing address

1311 Pineview Drive
Suite 200
Morgantown, WV 26505
Phone (304) 598-7546

Other identifiers 2

IdentifierTypeStateIssuer
001733619OtherWVBLUE CROSS BLUE SHIELD
1802385000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20040310000522 WV Practitioner - Dermatology 6800784885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
West Virginia University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1311 Pineview Dr
Suite 200
Morgantown, WV 26505-3276
Phone (304) 598-7546

Hospital & facility affiliations

  • Mon Health Medical Center Hospital, Morgantown, WV, CCN 510024
  • West Virginia University Hospitals, Inc Hospital, Morgantown, WV, CCN 510001

Merit-based Incentive Payment System (MIPS)

Final score
50 of 100Reported as individual
Quality
0
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions427
Skin biopsy134

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17968WVMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pineview Dermatology PLLC CurrentSince Jun 6, 2005 Accepting new patients

Locations

1311 Pineview Dr
Ste 200
Morgantown, WV 26505
Phone (304) 225-7549

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1356415533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 PINEVIEW DRIVE",
            "address_2": "SUITE 200",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26505",
            "telephone_number": "304-598-7546",
            "fax_number": "304-225-7551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 PINEVIEW DRIVE",
            "address_2": "SUITE 200",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26505",
            "telephone_number": "304-598-7546",
            "fax_number": "304-225-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "KENNETH",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WV",
            "license": "17968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "001733619",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1802385000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.