Individual provider Active NPI

Eileen Kenney, ANP

  • Adult Health Nurse Practitioner
  • Roslyn, NY
National Provider Identifier
1750401956
Registry record updated Nov 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F304316 Issued in NY
Practice address
100 Port Washington Blvd
Richard Shlofmitz, M.D.
Roslyn, NY 11576-1353
Phone
(516) 629-2467
Fax
(516) 629-2027
NPI assigned
Mar 30, 2007
Last updated
Nov 14, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F304316 NY Primary

Addresses

Primary practice location

100 Port Washington Blvd
Richard Shlofmitz, M.D.
Roslyn, NY 11576-1353

Mailing address

PO Box 1061
Port Washington, NY 11050-1061
Phone (516) 629-2467

Other identifiers 1

IdentifierTypeStateIssuer
02863981MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070711000762 NY Practitioner - Nurse Practitioner 3173623758 Reassigns benefits to 1 organization
Practice locations: Roslyn, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F304316NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, P.C CurrentSince Apr 14, 2021 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients

Locations

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

100 Port Washington Blvd
#1
Roslyn, NY 11576
Phone (516) 365-8372

100 Port Washington Blvd
#105
Roslyn, NY 11576
Phone (516) 390-9640

100 Port Washington Blvd
Ste 105
Roslyn, NY 11576
Phone (516) 390-9640

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226620800000",
    "number": "1750401956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1061",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110501061",
            "telephone_number": "516-629-2467",
            "fax_number": "516-629-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "address_2": "RICHARD SHLOFMITZ, M.D.",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761353",
            "telephone_number": "516-629-2467",
            "fax_number": "516-629-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "EILEEN",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2008-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F304316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02863981",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

Verify at the official NPI Registry.