Kenzie Kitcharoen, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036124514 Issued in IL

Practice address

515 Valley St Ste 203
Maplewood, NJ 07040-4300

Phone

(908) 663-2929

Fax

(908) 219-6213

NPI assigned

Aug 14, 2007

Last updated

Aug 18, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Psychiatry

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Stationmd Professional CorporationGroup PAC ID 6204184104, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233
• Garnet Health Medical Center Catskills Hospital, Harris, NY, CCN 330386

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.

• Stationmd Professional Corporation

  • Emergency Medicine Physician
  • Maplewood, NJ
  • NPI 1285015347

  NY, Psychiatry

  Medicare reassignment Care Compare group NPD
• K & Y Healthcare S.C.

  • Psychiatry Physician
  • Northbrook, IL
  • NPI 1720383086
  NPD Authorized official
• Asian Human Services of Chicago Inc.

  dba Asian Human Services Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Niles, IL
  • NPI 1740730266
  NPD (past)
• Asian Human Services, Inc.

  dba Trellus

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1548382690
  NPD (past)
• Professional Accounts Receivable Management Team

  dba Cognitive Counseling Center

  • Psychiatry Physician
  • Homewood, IL
  • NPI 1881760353
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Catskill Regional Medical Center

  dba CRMC Physician Services

  • Family Medicine Physician
  • Monticello, NY
  • NPI 1720039563

  Hospital

  Care Compare affiliation
• Garnet Health Medical Center Catskills

  • Rural Acute Care Hospital
  • Harris, NY
  • NPI 1710977012
  Care Compare affiliation
• Saint Anthony Medical Center

  dba OSF Saint Anthony Medical Center

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1790739977
  Care Compare affiliation

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1356533269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "899 SKOKIE BLVD SPC 333",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624023",
            "telephone_number": "847-834-1428",
            "fax_number": "855-265-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 VALLEY ST STE 203",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070404300",
            "telephone_number": "908-663-2929",
            "fax_number": "908-219-6213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "899 Skokie Blvd Spc 333",
            "address_purpose": "LOCATION",
            "city": "Northbrook",
            "state": "IL",
            "postal_code": "600624023",
            "country_code": "US",
            "telephone_number": "847-834-1428",
            "fax_number": "855-265-2722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KITCHAROEN",
        "first_name": "KENZIE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036124514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://app.luminello.com/kenziekitcharoenmd",
            "affiliation": "N",
            "address_1": "155 Revere Dr Ste 4",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600621558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychiatry Physician in Maplewood, NJ
• Providers in Maplewood, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.