Individual provider Active NPI

Kennedy Robinson

  • Physician Assistant
  • Milton, MA
National Provider Identifier
1427679596
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7930 Issued in MA
Practice address
100 Highland St Ste 226
Milton, MA 02186-3880
Phone
(617) 696-1826
NPI assigned
Apr 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 7930 MA Primary

Addresses

Primary practice location

100 Highland St Ste 226
Milton, MA 02186-3880

Mailing address

100 Highland St Ste 226
Milton, MA 02186-3880
Phone (617) 696-1826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20210625001780 MA Practitioner - Physician Assistant 4587065735 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Boston Urology LLCGroup PAC ID 1153516513, 44 clinicians

Practice addresses (Care Compare)

100 Highland St
Suite 201
Milton, MA 02186-3877
Phone (617) 696-1826

100 Highland St
Suite 226
Milton, MA 02186-3880
Phone (617) 696-1826

161 Worcester Rd
Framingham, MA 01701-5315

31 Roche Brothers Way
Suite 100
North Easton, MA 02356-1032
Phone (508) 238-0800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
7930MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Urology Institute LLC CurrentSince May 23, 2021 Accepting new patients
Gbu Bidco LLC Current Accepting new patients
Brockton Urology Clinic Inc Current Accepting new patients

Locations

360 Brockton Ave
Ste 201
Abington, MA 02351
Phone (339) 208-1303

161 Worcester Rd
Ste 602
Framingham, MA 01701
Phone (603) 479-4082

100 Highland St
Ste 201
Milton, MA 02186
Phone (617) 696-1820

100 Highland St
Ste 226
Milton, MA 02186
Phone (617) 696-1826

31 Roche Brothers Way
Ste 100
North Easton, MA 02356
Phone (508) 238-0800

Interoperability endpoints

  • Direct secure messaging: kennedyrobinson@gbu.medalliesdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1588204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1427679596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HIGHLAND ST STE 226",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021863880",
            "telephone_number": "617-696-1826",
            "fax_number": "617-696-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGHLAND ST STE 226",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021863880",
            "telephone_number": "617-696-1826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "KENNEDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-30",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "7930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, MA

Sources for this page

Verify at the official NPI Registry.