Individual provider Active NPI

Michael P. Kenney, D.O.

  • Internal Medicine Physician
  • Annapolis, MD
National Provider Identifier
1659431963
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
227094 Issued in NY
Practice address
695 Kinkaid Rd
Annapolis, MD 21402-1006
Phone
(410) 293-2273
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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 227094 NY Primary

Addresses

Primary practice location

695 Kinkaid Rd
Annapolis, MD 21402-1006

Mailing address

695 Kinkaid Rd
Annapolis, MD 21402-1006
Phone (410) 293-2273

Other identifiers 2

IdentifierTypeStateIssuer
227094OtherNYSTATE OF NY MEDICAL LICENSE #
03531239MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20130131000274 NY Practitioner - Internal Medicine 7416083100 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Medical PC Internal Medicine CurrentSince Jan 1, 2013 Accepting new patients
North Medical PC Internal Medicine Current Accepting new patients
Maryland Inpatient Care Specialists LLC Internal Medicine Past Accepting new patients

Locations

5100 W Taft Rd
Ste 1C
Liverpool, NY 13088
Phone (315) 452-2333

7209 Buckley Rd
Liverpool, NY 13088
Phone (315) 299-5451

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1659431963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 KINKAID RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214021006",
            "telephone_number": "410-293-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 KINKAID RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214021006",
            "telephone_number": "410-293-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "MICHAEL",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "227094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NY MEDICAL LICENSE #",
            "identifier": "227094",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03531239",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.