Individual provider Active NPI

Gary J Kennedy, MD

  • Geriatric Psychiatry Physician
  • Bronx, NY
National Provider Identifier
1669543047
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
140501 Issued in NY
Practice address
MMC - Dept. of Psychiatry
111 E. 210TH Street
Bronx, NY 10467
Phone
(718) 920-4236
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry Physician 2084P0805X 140501 NY Primary

Addresses

Primary practice location

MMC - Dept. of Psychiatry
111 E. 210TH Street
Bronx, NY 10467

Mailing address

446 E 86TH St
Apt. 11C
New York, NY 10028-6466
Phone (718) 920-4236

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
I20050106000756 NY Practitioner - Psychiatry 4981652922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Texas Medical Branch at Galveston, 1975
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Hospital & facility affiliations

  • Montefiore Medical Center Hospital, Bronx, NY, CCN 330059

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Aug 9, 1996 Accepting new patients
Montefiore Medical Center CurrentSince Aug 9, 1996 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: gkennedy@montefioredirect.com

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 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": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669543047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 E 86TH ST",
            "address_2": "APT. 11C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100286466",
            "telephone_number": "718-920-4236",
            "fax_number": "718-920-6538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MMC - DEPT. OF PSYCHIATRY",
            "address_2": "111 E. 210TH STREET",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-920-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "GARY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NY",
            "license": "140501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.