Individual provider Active NPI

Daniel William Kennedy, M.D.

  • Diagnostic Radiology Physician
  • Newark, OH
National Provider Identifier
1801004585
Registry record updated Nov 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
35.090631 Issued in OH
Practice address
1320 W Main St
Newark, OH 43055-1822
Phone
(740) 348-4710
Fax
(740) 348-4740
NPI assigned
May 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2014

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 57012390 OH
Body Imaging Physician 2085B0100X 35-090631 OH
Diagnostic Neuroimaging (Radiology) Physician 2085D0003X 35-090631 OH
Diagnostic Ultrasound Physician 2085U0001X 35-090631 OH
Hospice and Palliative Medicine (Radiology) Physician 2085H0002X 35-090631 OH
Neuroradiology Physician 2085N0700X 35-090631 OH
Nuclear Radiology Physician 2085N0904X 35-090631 OH
Radiation Oncology Physician 2085R0001X 35-090631 OH
Therapeutic Radiology Physician 2085R0203X 35-090631 OH
Vascular & Interventional Radiology Physician 2085R0204X 35-090631 OH
Nuclear Medicine Physician 207U00000X 35-090631 OH
In Vivo & In Vitro Nuclear Medicine Physician 207UN0903X 35-090631 OH
Nuclear Cardiology Physician 207UN0901X 35-090631 OH
Nuclear Imaging & Therapy Physician 207UN0902X 35-090631 OH
Diagnostic Radiology Physician 2085R0202X 35.090631 OH Primary

Addresses

Primary practice location

1320 W Main St
Newark, OH 43055-1822

Mailing address

PO Box 948
2112 Cherry Valley Rd.
Newark, OH 43058-0948
Phone (740) 522-3774

Other identifiers 2

IdentifierTypeStateIssuer
3039198MedicaidOH
P00880289OtherOHRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20100629000054 OH Practitioner - Diagnostic Radiology 5193856557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Creighton University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-County Radiologists IncGroup PAC ID 0840241907, 25 clinicians

Practice addresses (Care Compare)

1320 W Main St
Newark, OH 43055-1822
Phone (740) 348-5545

Hospital & facility affiliations

  • Licking Memorial Hospital Hospital, Newark, OH, CCN 360218
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • Genesis Hospital Hospital, Zanesville, OH, CCN 360039
  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085

Merit-based Incentive Payment System (MIPS)

Final score
97.5 of 100Reported as group
Quality
95
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-090631OHMDRadiation Oncology Physician
35.090631OHMDDiagnostic Radiology Physician
57012390OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-County Radiologists, Inc. Diagnostic Radiology CurrentSince Jan 1, 2015 Accepting new patients
Riverside Radiology and Interventional Associates Inc Diagnostic Radiology Past Accepting new patients

Locations

1320 W Main St
Newark, OH 43055
Phone (740) 348-4151

2000 Tamarack Rd
Newark, OH 43055
Phone (740) 788-6000

Interoperability endpoints

  • Direct secure messaging: daniel.kennedy@mmhs.medicity.net

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1801004585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 948",
            "address_2": "2112 CHERRY VALLEY RD.",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430580948",
            "telephone_number": "740-522-3774",
            "fax_number": "740-522-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 W MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551822",
            "telephone_number": "740-348-4710",
            "fax_number": "740-348-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "DANIEL",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "57012390",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "OH",
            "license": "35-090631",
            "primary": false
        },
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "OH",
            "license": "35-090631",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "OH",
            "license": "35-090631",
            "primary": false
        },
        {
            "code": "2085H0002X",
            "taxonomy_group": "",
            "desc": "Radiology, Hospice and Palliative Medicine",
            "state": "OH",
            "license": "35-090631",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "OH",
            "license": "35-090631",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "OH",
            "license": "35-090631",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "OH",
            "license": "35-090631",
            "primary": false
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "OH",
            "license": "35-090631",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OH",
            "license": "35-090631",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "OH",
            "license": "35-090631",
            "primary": false
        },
        {
            "code": "207UN0903X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, In Vivo & In Vitro Nuclear Medicine",
            "state": "OH",
            "license": "35-090631",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "OH",
            "license": "35-090631",
            "primary": false
        },
        {
            "code": "207UN0902X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
            "state": "OH",
            "license": "35-090631",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.090631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3039198",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00880289",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.