Keneil A Williams

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AG09220094 Issued in NJ

Practice address

268 McBride Ave
Building 2 Apt 3
Paterson, NJ 07501

Phone

(973) 413-5590

NPI assigned

Apr 3, 2023

Last updated

Apr 3, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Essex Gastro Associates, PAGroup PAC ID 2668447939, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.69 of 100Reported as group

Quality

88.93

Improvement activities

40

Cost

90.4

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Essex Gastro Associates, PA

  • Gastroenterology Physician
  • Newark, NJ
  • NPI 1114933926
  Medicare reassignment Care Compare group NPD
• Signify Health Medical Associates of New Jersey, LLC

  • General Practice Physician
  • Princeton, NJ
  • NPI 1174187728
  Medicare reassignment NPD
• Essex Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Newark, NJ
  • NPI 1891701611
  NPD (past)

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1407551286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 MCBRIDE AVE",
            "address_2": "BUILDING 2 APT 3",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "07501",
            "telephone_number": "973-413-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 MCBRIDE AVE",
            "address_2": "BUILDING 2 APT 3",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "07501",
            "telephone_number": "973-413-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KENEIL",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "AG09220094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wien Medical Group LLC
• Williams Drug, LLC (Williams Pharmacy)
• Williams Drug, LLC (Williams Pharmacy)
• Williams Health Care Agency, LLC
• April Williams
• Sharyn A Wills, APN
• Stephen Winikoff, M.D.
• Raheem Raleek Wise
• Alicja T. Witko, AU.D.
• Edward Wohrlin, LCSW

• Primary Care Nurse Practitioner in Paterson, NJ
• Providers in Paterson, NJ by specialty
• Primary Care Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.