NPIMap

Individual provider Active NPI

Harold V McKenna, MD

  • Internal Medicine Physician
  • South Amboy, NJ
National Provider Identifier
1609959550
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA03411800 Issued in NJ
Practice address
305 Main St
South Amboy, NJ 08879-1602
Phone
(732) 721-1120
Fax
(732) 721-2102
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA03411800 NJ Primary

Addresses

Primary practice location

305 Main St
South Amboy, NJ 08879-1602

Mailing address

305 Main Street
South Amboy, NJ 08879
Phone (732) 721-1120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051110000173 NJ Practitioner - Internal Medicine 5991723777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1975
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

305 Main St
South Amboy, NJ 08879-1602

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harold V McKenna, M.D., P.a. Internal Medicine CurrentSince Jan 1, 1989 Accepting new patients
HMH Hospitals Corporation Past Accepting new patients

Locations

530 New Brunswick Ave
Perth Amboy, NJ 08861
Phone (732) 324-5007

305 Main St
South Amboy, NJ 08879
Phone (732) 721-1120

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 9

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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1609959550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 MAIN STREET",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "08879",
            "telephone_number": "732-721-1120",
            "fax_number": "732-721-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MAIN ST",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088791602",
            "telephone_number": "732-721-1120",
            "fax_number": "732-721-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "HAROLD",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA03411800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Amboy, NJ

Sources for this page

Verify at the official NPI Registry.