Individual provider Active NPI

Katherine Kenny, M.D.

  • Internal Medicine Physician
  • Watsonville, CA
National Provider Identifier
1356494397
Registry record updated Jul 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A105752 Issued in CA
Practice address
50 Penny LN
Watsonville, CA 95076-3079
Phone
(831) 722-2010
Fax
(831) 722-2037
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A105752 CA Primary

Addresses

Primary practice location

50 Penny LN
Watsonville, CA 95076-3079

Mailing address

50 Penny LN
Watsonville, CA 95076-3079
Phone (831) 722-2010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081203000583 CA Practitioner - Internal Medicine 7810058286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tufts University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

850 Freedom Blvd
Watsonville, CA 95076-3814
Phone (831) 319-4595

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A105752CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alpana Gowda Inc CurrentSince May 2, 2018 Accepting new patients
Community Memorial Health System Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients

Locations

850 Freedom Blvd
Watsonville, CA 95076
Phone (831) 319-4595

50 Penny Ln
Watsonville, CA 95076
Phone (831) 722-2010

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1356494397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 PENNY LN",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950763079",
            "telephone_number": "831-722-2010",
            "fax_number": "831-722-2037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 PENNY LN",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950763079",
            "telephone_number": "831-722-2010",
            "fax_number": "831-722-2037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNY",
        "first_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A105752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsonville, CA

Sources for this page

Verify at the official NPI Registry.