Individual provider Active NPI

Kimberly McEnery, PA

  • Physician Assistant
  • Woonsocket, RI
National Provider Identifier
1669430856
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00337 Issued in RI
Practice address
115 Cass Ave
Woonsocket, RI 02895-4705
Phone
(401) 769-4100
NPI assigned
May 4, 2006
Last updated
Jul 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00337 RI Primary

Addresses

Primary practice location

115 Cass Ave
Woonsocket, RI 02895-4705

Mailing address

350 Spring Green Rd
Warwick, RI 02888-5342
Phone (401) 437-6375

Other practice location 1

100 Kenyon Ave
Wakefield, RI 02879-4216
Phone (401) 782-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061002000339 RI Practitioner - Physician Assistant 0840252664 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Care Services of New England PCGroup PAC ID 9739487562, 23 clinicians

Practice addresses (Care Compare)

200 High Service Ave
North Providence, RI 02904-5113
Phone (401) 456-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA00337RIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Step Ri, PC Past Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is Past Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is Past Accepting new patients

Organizations & group practices 6

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 1

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1669430856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 SPRING GREEN RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028885342",
            "telephone_number": "401-437-6375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CASS AVE",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028954705",
            "telephone_number": "401-769-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Kenyon Ave",
            "address_purpose": "LOCATION",
            "city": "Wakefield",
            "state": "RI",
            "postal_code": "028794216",
            "country_code": "US",
            "telephone_number": "401-782-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCENERY",
        "first_name": "KIMBERLY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA00337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

Verify at the official NPI Registry.