Individual provider Active NPI

Kendrick Simon Abad, DO

  • Psychiatry Physician
  • Mount Holly, NJ
National Provider Identifier
1720729346
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MB12913100 Issued in NJ
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

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260613000029 NJ Practitioner - PsychiatryPractitioner - Neurology 9234601923

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Neurology
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

Verify at the official NPI Registry.