Individual provider Active NPI

Jonathan Kilroy, DO

  • Family Medicine Physician
  • Derry, NH
National Provider Identifier
1578534806
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11920 Issued in NH
Practice address
6 Tsienneto Rd
Suite 100
Derry, NH 03038
Phone
(603) 537-1300
NPI assigned
Jan 26, 2006
Last updated
Aug 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11920 NH Primary

Addresses

Primary practice location

6 Tsienneto Rd
Suite 100
Derry, NH 03038

Mailing address

6 Buttrick Rd Ste 102
Londonderry, NH 03053-3417
Phone (603) 537-1300

Other identifiers 6

IdentifierTypeStateIssuer
30222464MedicaidNH
04YP05263NH01OtherNHANTHEM BCBS
3311149OtherNHAETNA USHC
465375OtherNHTUFTS
AA7125OtherNHHARVARD
SX2967OtherNHMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20040214000126 NH Practitioner - Family Practice 6800780362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Derry Medical Center, PAGroup PAC ID 5294711768, 98 clinicians

Practice addresses (Care Compare)

6 Tsienneto Rd
Suite 100
Derry, NH 03038-1584
Phone (603) 537-1300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11920NHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Derry Medical Center, PA Family Medicine CurrentSince Nov 2, 2004 Accepting new patients

Locations

14 Tsienneto Rd
Bldg B
Derry, NH 03038

6 Tsienneto Rd
Ste 100
Derry, NH 03038

6 Buttrick Rd
Ste 102
Londonderry, NH 03053
Phone (603) 537-1308

6 Old Fremont Road Ext
Raymond, NH 03077
Phone (603) 537-1363

49 Range Rd
Ste 104
Windham, NH 03087

Interoperability endpoints

  • Direct secure messaging: jonathankilroy@dmcnh.allscriptsdirect.net

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1578534806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BUTTRICK RD STE 102",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533417",
            "telephone_number": "603-537-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TSIENNETO RD",
            "address_2": "SUITE 100",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "03038",
            "telephone_number": "603-537-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILROY",
        "first_name": "JONATHAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "11920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30222464",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "04YP05263NH01",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USHC",
            "identifier": "3311149",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "465375",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD",
            "identifier": "AA7125",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "SX2967",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

Verify at the official NPI Registry.