Active NPI
Robert J Kennedy, MD
- Ophthalmology Physician
- Schenectady, NY
National Provider Identifier
1801817424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 1589361
- Practice address
- 1675 Providence Avenue
Schenectady, NY 12309 - Phone
- (518) 377-3439
- NPI assigned
- Jul 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 1589361 | NY | Primary |
Addresses
Primary practice location
1675 Providence Avenue
Schenectady, NY 12309
Mailing address
1675 Providence Avenue
Schenectady, NY 12309
Phone (518) 377-3439
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000405575002 | Other | BS | |
| 00864755 | Medicaid | NY | |
| 10001042 | Other | CDPHP | |
| 17111 | Other | MVP |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- Georgetown University School of Medicine, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1675 Providence Ave
Schenectady, NY 12309-3919
Phone (518) 377-3439
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 15 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1589361 | NY | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kennedy Ophthalmology Associates PLLC | Ophthalmology | Current | Accepting new patients |
| Kennedy Ophthalmic Associates PLLC | Ophthalmology | Past | Accepting new patients |
Locations
1675 Providence Ave
Schenectady, NY 12309
Phone (518) 377-3410
Interoperability endpoints
- rkennedy834602@direct.trinity-health.org
- robert.kennedy@kennedyophthalmologyassociates.chartmakerdirect.com
- rkennedy@kennedyophthalmology.direct.eyemdemr.com
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.
-
- Ophthalmology Physician
- Schenectady, NY
- NPI 1215150552
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801817424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1675 PROVIDENCE AVENUE",
"city": "SCHENECTADY",
"state": "NY",
"postal_code": "12309",
"telephone_number": "518-377-3439",
"fax_number": "518-377-0436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1675 PROVIDENCE AVENUE",
"city": "SCHENECTADY",
"state": "NY",
"postal_code": "12309",
"telephone_number": "518-377-3439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "ROBERT",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NY",
"license": "1589361",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BS",
"identifier": "000405575002",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00864755",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPHP",
"identifier": "10001042",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "17111",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Schenectady, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.