Active NPI
Kendrick Simon Abad, DO
- Psychiatry Physician
- Mount Holly, NJ
National Provider Identifier
1720729346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 25MB12913100
- Practice address
- 175 Madison Avenue 6TH Floor
Mount Holly, NJ 08060 - Phone
- (609) 444-0221
- Fax
- (856) 325-5222
- NPI assigned
- Apr 6, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 25MB12913100 | NJ | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
175 Madison Avenue 6TH Floor
Mount Holly, NJ 08060
Mailing address
301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (609) 444-0221
Other practice location 1
1925 Pacific Ave
Atlantic City, NJ 08401-6713
Phone (609) 345-4000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kabad319352@directvirtua.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260613000029 | NJ | Practitioner - Psychiatry | 9234601923 |
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Rowan University School of Osteopathic Medicine, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
301 Lippincott Dr
Marlton, NJ 08053-4178
303 Lippincott Dr
Suite 200
Marlton, NJ 08053-4160
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787529600000",
"number": "1720729346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 LIPPINCOTT DR STE 410",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080534197",
"telephone_number": "609-444-0221",
"fax_number": "856-325-5222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 MADISON AVENUE 6TH FLOOR",
"city": "MOUNT HOLLY",
"state": "NJ",
"postal_code": "08060",
"telephone_number": "609-444-0221",
"fax_number": "856-325-5222"
}
],
"practiceLocations": [
{
"address_1": "1925 Pacific Ave",
"address_purpose": "LOCATION",
"city": "Atlantic City",
"state": "NJ",
"postal_code": "084016713",
"country_code": "US",
"telephone_number": "609-345-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ABAD",
"first_name": "KENDRICK",
"middle_name": "SIMON",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-06",
"last_updated": "2026-08-24",
"certification_date": "2026-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NJ",
"license": "25MB12913100",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kabad319352@directvirtua.org",
"affiliation": "N",
"address_1": "175 Madison Avenue 6th Floor",
"city": "Mount Holly",
"state": "NJ",
"country_code": "US",
"postal_code": "08060",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Mount Holly, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; 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.