Active NPI
Roger L Kinnard, MD
- Neurological Surgery Physician
- Melrose, MA
National Provider Identifier
1437247293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 59856
- Practice address
- 792 Main St
Melrose, MA 02176-2710 - Phone
- (781) 665-2255
- Fax
- (781) 665-2246
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 59856 | MA | Primary |
Addresses
Primary practice location
792 Main St
Melrose, MA 02176-2710
Mailing address
792 Main St
Melrose, MA 02176-2710
Phone (781) 665-2255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3039897 | Medicaid | MA |
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050616001087 | MA | Practitioner - Neurology | 4587608831 | Practice locations: Melrose, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- R Franklin University of Med & Sci/Chicago Medical School, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
792 Main St
Melrose, MA 02176-2710
Phone (781) 665-2255
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437247293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "792 MAIN ST",
"city": "MELROSE",
"state": "MA",
"postal_code": "021762710",
"telephone_number": "781-665-2255",
"fax_number": "781-665-2246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "792 MAIN ST",
"city": "MELROSE",
"state": "MA",
"postal_code": "021762710",
"telephone_number": "781-665-2255",
"fax_number": "781-665-2246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINNARD",
"first_name": "ROGER",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "MA",
"license": "59856",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3039897",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Melrose, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.