Individual provider Active NPI

Kyle Kennedy, MD

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1801475041
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
332314-01 Issued in NY
Practice address
1901 1St Ave # 2A31
New York, NY 10029-7494
Phone
(213) 423-6684
NPI assigned
Apr 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 332314-01 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1901 1St Ave # 2A31
New York, NY 10029-7494

Mailing address

1901 1St Ave # 2A31
New York, NY 10029-7494
Phone (213) 423-6684

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241025000662 NY Practitioner - Emergency Medicine 2365975604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians

Practice addresses (Care Compare)

506 Lenox Ave
New York, NY 10037-1802
Phone (212) 939-1840

Hospital & facility affiliations

  • Metropolitan Hospital Center Hospital, New York, NY, CCN 330199

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
332314-01NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Affiliate Group of New York PC CurrentSince Aug 8, 2024 Accepting new patients

Locations

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

1901 1st Ave
Rm 5M44
New York, NY 10029
Phone (212) 423-6262

1901 1st Ave
#2A31
New York, NY 10029
Phone (212) 423-6684

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

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 1

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": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1801475041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 1ST AVE # 2A31",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297494",
            "telephone_number": "213-423-6684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 1ST AVE # 2A31",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297494",
            "telephone_number": "213-423-6684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-05",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "332314-01",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.