Individual provider Active NPI

Kathleen A Kennedy, MD

  • Cardiovascular Disease Physician
  • Hartford, CT
National Provider Identifier
1568455194
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
026843 Issued in CT
Practice address
19 Woodland St
Ste 35
Hartford, CT 06105-2372
Phone
(860) 525-1234
Fax
(860) 278-8782
NPI assigned
Aug 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 026843 CT Primary

Addresses

Primary practice location

19 Woodland St
Ste 35
Hartford, CT 06105-2372

Mailing address

19 Woodland St
Ste 47
Hartford, CT 06105-2372
Phone (860) 525-4005

Other identifiers 8

IdentifierTypeStateIssuer
060052425OtherRAILROAD MEDICARE
HAS544OtherCTOXFORD
001268433MedicaidCT
0004244738OtherAETNA
2083418OtherAETNA
00126843301OtherANTHEM BCBS
010026843CT03OtherANTHEM BCBS
708620OtherCTCONNECTICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20090902000483 CT Practitioner - Cardiovascular Disease (Cardiology) 3678628211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Albany Medical College of Union University, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
026843CTMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Sep 23, 2010 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Cardiovascular Disease CurrentSince Sep 23, 2010 Accepting new patients

Locations

19 Woodland St
Ste 35
Hartford, CT 06105
Phone 20321768760

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

19 Woodland St
Ste 47
Hartford, CT 06105

1000 Asylum Ave
Ste 4310
Hartford, CT 06105
Phone (860) 247-2137

19 Woodland St
Ste 45
Hartford, CT 06105
Phone (860) 527-1669

Interoperability endpoints

  • Direct secure messaging: kkennedy2377200@direct.trinity-health.org

Organizations & group practices 2

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 3

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1568455194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 WOODLAND ST",
            "address_2": "STE 47",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052372",
            "telephone_number": "860-525-4005",
            "fax_number": "860-525-4839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 WOODLAND ST",
            "address_2": "STE 35",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052372",
            "telephone_number": "860-525-1234",
            "fax_number": "860-278-8782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "026843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060052425",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "HAS544",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001268433",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004244738",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2083418",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "00126843301",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "010026843CT03",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "708620",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.