Individual provider Active NPI

Kevin Patrick Kenney, MD

  • Vascular Surgery Physician
  • Gainesville, FL
National Provider Identifier
1740741651
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
ME169566 Issued in FL
Practice address
4645 NW 8TH Ave
Gainesville, FL 32605-4524
Phone
(352) 375-1212
Fax
(352) 371-4650
NPI assigned
Mar 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Vascular Surgery Physician 2086S0129X ME169566 FL Primary

Addresses

Primary practice location

4645 NW 8TH Ave
Gainesville, FL 32605-4524

Mailing address

4645 NW 8TH Ave
Gainesville, FL 32605-4524
Phone (352) 375-1212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240910002325 FL Practitioner - Vascular Surgery 1153657580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
New York Medical College, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Interventional Cardiologists of Gainesville, PAGroup PAC ID 8820077241, 36 clinicians

Practice addresses (Care Compare)

4645 NW 8TH Ave
Suite 20
Gainesville, FL 32605-4688
Phone (352) 375-1212

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Varicose vein removal66
Leg revascularization (restoring blood flow)85
Removal of tissue66

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME169566FLMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Cardiologists of Gainesville, PA CurrentSince Aug 19, 2024 Accepting new patients

Locations

1151 NW 64th Ter
Gainesville, FL 32605
Phone (352) 331-8570

4645 NW 8th Ave
Ste 20
Gainesville, FL 32605
Phone (352) 375-1212

4645 NW 8th Ave
Gainesville, FL 32605
Phone (352) 264-2500

3239 NW York Dr
Lake City, FL 32055
Phone (352) 375-1212

Organizations & group practices 1

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 2

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": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1740741651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 NW 8TH AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054524",
            "telephone_number": "352-375-1212",
            "fax_number": "352-371-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 NW 8TH AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054524",
            "telephone_number": "352-375-1212",
            "fax_number": "352-371-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "KEVIN",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-26",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME169566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.