Individual provider Active NPI

Maura A. Kenney- Kieran, A.N.P.-C

  • Adult Health Nurse Practitioner
  • Roslyn, NY
National Provider Identifier
1376549725
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F3033691 Issued in NY
Practice address
1405 Old Northern Blvd
Roslyn, NY 11576-2252
Phone
(516) 484-6777
Fax
(516) 484-0037
NPI assigned
Jun 21, 2005
Last updated
Jan 20, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F3033691 NY Primary

Addresses

Primary practice location

1405 Old Northern Blvd
Roslyn, NY 11576-2252

Mailing address

1405 Old Northern Blvd
Roslyn, NY 11576-2252
Phone (516) 484-6777

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101104001323 NY Practitioner - Nurse Practitioner 6901090703 Reassigns benefits to 1 organization
Practice locations: Roslyn, NY; Greenvale, NY

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

1405 Old Northern Blvd
Roslyn, NY 11576-2252
Phone (516) 484-6777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
303369NYMDObstetrics & Gynecology Physician
F3033691NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, P.C CurrentSince Jan 1, 2016 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
St Catherine of Siena Medical Center Past Accepting new patients
St. Catherine's Bone Density Past Accepting new patients
New York Cardiology Group, P.C. PastSince Jan 1, 2016 Accepting new patients

Locations

2200 Northern Blvd
Ste 112
Greenvale, NY 11548
Phone (516) 484-6777

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

1405 Old Northern Blvd
Roslyn, NY 11576
Phone (516) 484-6777

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: mkenneykieran12030@direct-chsli.net

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1376549725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 OLD NORTHERN BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115762252",
            "telephone_number": "516-484-6777",
            "fax_number": "516-484-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 OLD NORTHERN BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115762252",
            "telephone_number": "516-484-6777",
            "fax_number": "516-484-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY- KIERAN",
        "first_name": "MAURA",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "A.N.P.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F3033691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

Verify at the official NPI Registry.