Kennedy M Zaccheo, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2022-0056 Issued in NM

Practice address

2100 Louisiana Blvd NE Ste 410
Albuquerque, NM 87110-5412

Phone

(505) 724-4300

Fax

(505) 724-4300

NPI assigned

Apr 15, 2021

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

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kzaccheo867774@ahs.direct-ci.com

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.

• New Mexico Orthopaedic Associates PC

  • Orthopaedic Surgery Physician
  • Albuquerque, NM
  • NPI 1407898299
  Medicare reassignment NPD

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1417538117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 CLARENDON ST APT 4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162012",
            "telephone_number": "775-200-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 LOUISIANA BLVD NE STE 410",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105412",
            "telephone_number": "505-724-4300",
            "fax_number": "505-724-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACCHEO",
        "first_name": "KENNEDY",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-15",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2022-0056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeff Scott Zabel, MD
• Kenneth Matthew Zabel, MD
• Mohammad Zabihi, ED.D, LPCC
• Leobarda Zacarias, LPCC, NCC
• Timothy Zaccaria
• Millie Ann Zachariah
• James Langley Zacharias, PH.D.
• Elisa Zachary, LCSW
• Judith Zachary, RN
• Vance Edward Zachary, M.D.

• Physician Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.