Active NPI
Peter John Kennedy, MSN, NP-C
- Gerontology Nurse Practitioner
- Burlington, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- RN2308844
- Practice address
- 41 Mall Rd
Burlington, MA 01805-5491 - NPI assigned
- Aug 22, 2020
- Last updated
- Jan 16, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN2308844 | MA | |
| Gerontology Nurse Practitioner | 363LG0600X | RN2308844 | MA | Primary |
Addresses
Primary practice location
41 Mall Rd
Burlington, MA 01805-5491
Mailing address
330 Brookline Ave
Boston, MA 02215-5491
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Lahey Clinic Inc
Practice addresses (Care Compare)
1 Essex Ctr Dr
Peabody, MA 01960-2901
Phone (978) 538-4000
29 Mall Rd
Burlington, MA 01805-0001
41 Mall Rd
Burlington, MA 01805-0001
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2308844 | MA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lahey Clinic, Inc | Current | Accepting new patients | |
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Current | Accepting new patients | |
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Current | Accepting new patients | |
| Beth Israel Deaconess Medical Center, Inc. | Current | Accepting new patients | |
| Lahey Clinic, Inc. | Current | Accepting new patients | |
| Beth Israel Deaconess Medical Center, Inc. | Current | Accepting new patients | |
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Past | Accepting new patients |
Locations
330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000
41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400
Interoperability endpoints
- pkennedy251387@direct.bilh.masshiway.net
Organizations & group practices 7
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.
-
- General Acute Care Hospital
- Boston, MA
- NPI 1548202641
-
- Internal Medicine Physician
- Boston, MA
- NPI 1194765438
-
- Internal Medicine Physician
- Peabody, MA
- NPI 1063447316
-
- Ambulance
- Boston, MA
- NPI 1518600501
-
dba Emergency Medicine - HMFP at BIDMC
- Emergency Medicine Physician
- Boston, MA
- NPI 1316987993
-
dba Dermatology - HMFP at BIDMC
- Dermatology Physician
- Boston, MA
- NPI 1043250616
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Boston, MA
- NPI 1548202641
-
- General Acute Care Hospital
- Burlington, MA
- NPI 1558392563
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705363200000",
"number": "1558973396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 BROOKLINE AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "022155491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 MALL RD",
"city": "BURLINGTON",
"state": "MA",
"postal_code": "018055491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "PETER",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"credential": "MSN, NP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-22",
"last_updated": "2024-01-16",
"certification_date": "2024-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "RN2308844",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MA",
"license": "RN2308844",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Burlington, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.