Individual provider Active NPI

Kerry A Murphy, MD

  • Family Medicine Physician
  • Mattituck, NY
National Provider Identifier
1396764288
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
210366 Issued in NY
Practice address
11700 Main Rd
Mattituck, NY 11952-1525
Phone
(631) 963-4770
NPI assigned
Jul 19, 2006
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 210366 NY Primary

Addresses

Primary practice location

11700 Main Rd
Mattituck, NY 11952-1525

Mailing address

11700 Main Rd
Mattituck, NY 11952-1525

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmurphy238874@nyumc.direct-ci.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100923000355 NY Practitioner - Internal MedicinePractitioner - Family Practice 5698891034 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
Winthrop Community Medical Affiliates PC Family Medicine Past Accepting new patients
Island Urgent Medical Care, P.C. Family Medicine Past Accepting new patients

Locations

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

11700 Main Rd
Mattituck, NY 11952
Phone (631) 298-5376

715 Roanoke Ave
Riverhead, NY 11901
Phone (631) 298-4655

715 Roanoke Ave
Ste 3
Riverhead, NY 11901
Phone (631) 963-4770

Interoperability endpoints

  • Direct secure messaging: kmurphy238874@nyumc.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1396764288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11700 MAIN RD",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "119521525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 MAIN RD",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "119521525",
            "telephone_number": "631-963-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURPHY",
        "first_name": "KERRY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "210366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmurphy238874@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "11700 Main Rd",
            "city": "Mattituck",
            "state": "NY",
            "country_code": "US",
            "postal_code": "119521525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mattituck, NY

Sources for this page

Verify at the official NPI Registry.