Bethany H Kennedy, ANP, MSN, RN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

306535 Issued in NY

Practice address

2171 Jericho Tpke Ste 135
Commack, NY 11725-2947

Phone

(631) 670-6525

NPI assigned

Jul 7, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, TX2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Millennium Medical Professionals, PLLCGroup PAC ID 3971747296, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bkennedy132046@direct-chsli.net

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.

• Millennium Medical Professionals, PLLC

  • Cardiovascular Disease Physician
  • Smithtown, NY
  • NPI 1114364510
  Medicare reassignment Care Compare group NPD
• Post Acute Specialists of Texas PA

  • Geriatric Medicine (Family Medicine) Physician
  • Austin, TX
  • NPI 1942859350
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• John T. Mather Memorial Hospital

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1093718728
  Care Compare affiliation

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

{
    "created_epoch": "1373155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412467200000",
    "number": "1710328760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2171 JERICHO TPKE STE 135",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252947",
            "telephone_number": "631-670-6525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2171 JERICHO TPKE STE 135",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252947",
            "telephone_number": "631-670-6525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "BETHANY",
        "middle_name": "H",
        "credential": "ANP, MSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-07",
        "last_updated": "2014-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "306535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dejon Paul Kelly
• Laura Jean Kelly, RD, CSO, CDN
• Maureen Jeanette Kelly, P.A.
• Stephen Patrick Kelly, COTA
• Andrea Michelle Keltos, LMSW
• Gregory Wayne Kennedy, DDS
• Regina Kent, OTR/L
• Shannon L Kerekes, MS OTR/L
• Alyssa Danielle Kerr, PA-C
• David Lawrence Kessler, PHD

• Adult Health Nurse Practitioner in Commack, NY
• Providers in Commack, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2014; 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.