Stephen David Kanarek, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35470 Issued in MA

Practice address

10 Centennial Dr
Peabody, MA 01960

Phone

(978) 535-1110

Fax

(978) 535-2907

NPI assigned

Mar 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: skanarek6034@direct.chppoc.masshiway.net

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.

• Pediatric Health Care Associates PC

  • Pediatrics Physician
  • Peabody, MA
  • NPI 1821153180
  NPD (past) Authorized official

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344556800000",
    "number": "1447219944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CENTENNIAL DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "01960",
            "telephone_number": "978-535-1110",
            "fax_number": "978-535-2907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CENTENNIAL DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "01960",
            "telephone_number": "978-535-1110",
            "fax_number": "978-535-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAREK",
        "first_name": "STEPHEN",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2012-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "35470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2006197",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Iris Kaddis, MD
• Stephen Spencer Kalivas, R.PH.
• Louise Kalumba
• Alexis Kaminski-Mainardi
• Justin Paul Kaminski, DPM
• Tabitha Kanyua
• Jessica Lori Kaptcianos, MA, MT-BC
• Cassandra P Karamourtopoulos
• John Karbassi, M.D.
• Karen Neckers OD

• Pediatrics Physician in Peabody, MA
• Providers in Peabody, MA by specialty
• Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; 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.