Kelly Rose Birchenough, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

298638 Issued in NY

Practice address

830 Washington St
Watertown, NY 13601-4099

Phone

(315) 786-4900

NPI assigned

Apr 21, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kelly Rose Ferguson Former name

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

Merit-based Incentive Payment System (MIPS)

Final score

85.28 of 100Reported as group

Quality

75.06

Promoting interoperability

100

Improvement activities

40

Cost

69.26

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• MVHS Inc

  • Family Medicine Physician
  • Utica, NY
  • NPI 1770690737
  Medicare reassignment NPD
• Samaritan Medical Center

  • General Acute Care Hospital
  • Watertown, NY
  • NPI 1598713745
  Medicare reassignment NPD
• MVHS Inc

  • Community/Retail Pharmacy
  • Utica, NY
  • NPI 1306573753
  NPD
• Samaritan Medical Center

  • Rehabilitation Hospital Unit
  • Watertown, NY
  • NPI 1093722068
  NPD
• MVHS Inc

  • General Acute Care Hospital
  • Utica, NY
  • NPI 1205877172
  NPD (past)
• MVHS Inc

  • General Acute Care Hospital
  • Utica, NY
  • NPI 1649350380
  NPD (past)

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

{
    "created_epoch": "1303344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1710278957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014099",
            "telephone_number": "315-786-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014099",
            "telephone_number": "315-786-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRCHENOUGH",
        "first_name": "KELLY",
        "middle_name": "ROSE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-21",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "OS017606",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "298638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "FERGUSON",
            "middle_name": "ROSE",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bhupinder Singh Bolla MD PLLC
• Bhupinder Singh Bolla MD PLLC
• John Henry Bialik, PA
• Willard James Bice
• Erin L. Birchenough, NP
• Christopher Philip Black, M.D.
• Julee Blackwell
• Joyce Blosser
• Laura Ellen Boggs, DO
• Mia Boissevain

• Obstetrics & Gynecology Physician in Watertown, NY
• Providers in Watertown, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; 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.