Derek Kennedy

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

292055 Issued in NY

Practice address

207 Foote Ave
Jamestown, NY 14701-7077

Phone

(716) 664-8120

NPI assigned

Apr 5, 2013

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY, AZ2 enrollments

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 2

Specialty

Emergency Medicine

Education

Yale University School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Group of Arizona Professional CorporationGroup PAC ID 1355596644, 102 clinicians

Emergency Physician Services of New York, P.C.Group PAC ID 8325939804, 128 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northern Dutchess Hospital Hospital, Rhinebeck, NY, CCN 330049
• Putnam Hospital Center Hospital, Carmel, NY, CCN 330273
• Abrazo Central Campus Hospital, Phoenix, AZ, CCN 030030
• St Peter'S Hospital Hospital, Albany, NY, CCN 330057

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 and National Provider Directory roles.

• Emergency Physician Services of New York, P.C.

  • Emergency Medicine Physician
  • Poughkeepsie, NY
  • NPI 1093759847
  Medicare reassignment Care Compare group NPD
• Emergency Group of Arizona Professional Corporation

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1215275433
  Medicare reassignment Care Compare group NPD
• Emergency Care Services of New York, P.C.

  • Emergency Medicine Physician
  • Syracuse, NY
  • NPI 1639236656
  Medicare reassignment NPD
• Great Lakes Physician Practice PC

  • Internal Medicine Physician
  • Jamestown, NY
  • NPI 1730599176

  Emergency Medicine

  Medicare reassignment NPD
• Island Emergency Medical Services, P.C.

  • Emergency Medicine Physician
  • Far Rockaway, NY
  • NPI 1639160385
  Medicare reassignment NPD
• Massena Hospital Inc

  • Critical Access Hospital
  • Massena, NY
  • NPI 1972604460
  Medicare reassignment
• Jamestown Area Medical Associates, L.L.P.

  • Internal Medicine Physician
  • Jamestown, NY
  • NPI 1528010766
  NPD
• Massena Hospital, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Massena, NY
  • NPI 1619756640
  NPD

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

• Northern Dutchess Hospital

  • General Acute Care Hospital
  • Rhinebeck, NY
  • NPI 1124072715
  Care Compare affiliation
• Putnam Hospital Center

  • General Acute Care Hospital
  • Carmel, NY
  • NPI 1972557379
  Care Compare affiliation
• St. Peter'S Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106
  Care Compare affiliation
• VHS of Phoenix Inc

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1477537363
  Care Compare affiliation

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

{
    "created_epoch": "1365120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1396088571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5950 BOWMAN RD",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 FOOTE AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147017077",
            "telephone_number": "716-664-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "DEREK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-05",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "70765",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "292055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "upmchospitals@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kathleen E. Grace LLC
• Akashdeep Kaur-Brar
• Daniel Allyn Keefe, R.N.
• Jessica Marie Keeler
• Brooke K Kelly, DO
• Amanda Rose Kent, PMHNP
• Peggy Sue Kestler, NP
• Tariq Mahmood Khan, M.D.
• Kiantone Independent Fire Department, Inc.
• Elizabeth Kidder, MD

• Emergency Medicine Physician in Jamestown, NY
• Providers in Jamestown, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.