Kenneth V. Master, M.D.

Primary specialty

Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X

License

25MA06269400 Issued in NJ

Practice address

1045 James St
Syracuse, NY 13203-2730

Phone

(315) 472-4471

NPI assigned

Jun 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA, NY2 enrollments

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 2

Specialty

PsychiatryAlso: Geriatric Psychiatry

Education

University of Cincinnati College of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Danville Hospital Opco LLCGroup PAC ID 3173025988, 2 clinicians

Glenmaura Holdings, LLCGroup PAC ID 3173989456, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmaster2388901@direct.trinity-health.org

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.

• Danville Hospital Opco LLC

  • Psychiatric Hospital
  • Danville, PA
  • NPI 1790576049
  Medicare reassignment Care Compare group NPD
• Glenmaura Holdings, LLC

  • Psychiatric Hospital
  • Moosic, PA
  • NPI 1942914924
  Medicare reassignment Care Compare group NPD
• Liberty Resources Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Syracuse, NY
  • NPI 1225254881
  Medicare reassignment NPD
• St Josephs Hospital Health Center

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1508815333
  Medicare reassignment NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment NPD
• Liberty Resources, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fulton, NY
  • NPI 1700688827
  NPD
• St Joseph'S Hospital Health Center

  • Internal Medicine Physician
  • Syracuse, NY
  • NPI 1699832436

  Psychiatry

  NPD
• St. Joseph'S Pathology, PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Syracuse, NY
  • NPI 1235121575
  NPD
• Geisinger Clinic

  • Pediatrics Physician
  • Forty Fort, PA
  • NPI 1427291947
  NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD
• Geisinger Medical Center

  • Psychiatric Hospital Unit
  • Danville, PA
  • NPI 1144301102
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1659317949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WHITE HORSE PIKE",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351294",
            "telephone_number": "856-310-0042",
            "fax_number": "856-310-0092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032730",
            "telephone_number": "315-472-4471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "717-531-8338",
            "fax_number": "717-531-6250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 White Horse Pike",
            "address_purpose": "LOCATION",
            "city": "Haddon Heights",
            "state": "NJ",
            "postal_code": "080351294",
            "country_code": "US",
            "telephone_number": "856-310-0042",
            "fax_number": "856-310-0092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASTER",
        "first_name": "KENNETH",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD047765L",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NJ",
            "license": "25MA06269400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6917007",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia J Massay-Donato, LMFT
• Cathey A. Massey, M.A., CCC-SLP
• Jarrett Masson, MD
• Jeremy James Massoud
• Cassandra Mastellar
• Joseph Charles Masterleo, LCSW - DCSW
• Kimberly Ann Masterpole, LCSWR
• Jill K Masters, PT
• Bailey Elizabeth Masterson, LMSW
• Bryan Masterson, PA-C

• Geriatric Psychiatry Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Geriatric Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.

Verify at the official NPI Registry.