Kenneth M Brock, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

330543 Issued in NY

Practice address

19 The Pines
Old Westbury, NY 11568-1126

Phone

(516) 633-1436

NPI assigned

Apr 13, 2016

Last updated

Jul 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ, CT, WI, MI5 enrollments

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 5

Specialty

Diagnostic Radiology

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Group practices

Millennium Medical Imaging PCGroup PAC ID 5799776910, 34 clinicians

Niagara Frontier Radiologic Associates PCGroup PAC ID 0345349387, 21 clinicians

Radiology Affiliates of Central New Jersey PCGroup PAC ID 1759277239, 129 clinicians

Sra Medical Imaging LLCGroup PAC ID 1759369663, 40 clinicians

Empire State Radiology P CGroup PAC ID 4385075241, 266 clinicians

East Post Road Medical Services PCGroup PAC ID 6406198506, 419 clinicians

Coastal Imaging LLCGroup PAC ID 8123312055, 68 clinicians

Nuvance Health Medical Practice PCGroup PAC ID 1658468442, 578 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vassar Brothers Medical Center Hospital, Poughkeepsie, NY, CCN 330023
• Hackensack Meridian Mountainside Medical Hospital, Montclair, NJ, CCN 310054
• Garnet Health Medical Center Hospital, Middletown, NY, CCN 330126
• Montefiore St Luke's Cornwall Hospital, Newburgh, NY, CCN 330264
• St Marys Healthcare Hospital, Amsterdam, NY, CCN 330047

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 30)

Networks

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

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ei-jefferson

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.

• East Post Road Medical Services PC

  • Emergency Medicine Physician
  • White Plains, NY
  • NPI 1841767274

  Diagnostic Radiology, NJ

  Medicare reassignment Care Compare group NPD
• Empire State Radiology P C

  • Diagnostic Radiology Physician
  • West Islip, NY
  • NPI 1255962783

  NJ

  Medicare reassignment Care Compare group NPD
• Millennium Medical Imaging PC

  • Diagnostic Radiology Physician
  • Saratoga Springs, NY
  • NPI 1235114182
  Medicare reassignment Care Compare group NPD
• Niagara Frontier Radiologic Associates PC

  • Diagnostic Radiology Physician
  • Lewiston, NY
  • NPI 1225120850

  NJ

  Medicare reassignment Care Compare group NPD
• Nuvance Health Medical Practice PC

  • Internal Medicine Physician
  • Poughkeepsie, NY
  • NPI 1437358033

  NJ

  Medicare reassignment Care Compare group NPD
• Sra Medical Imaging LLC

  • Diagnostic Radiology Physician
  • Buffalo, NY
  • NPI 1881920452

  NJ

  Medicare reassignment Care Compare group NPD
• Coastal Imaging LLC

  • Diagnostic Radiology Physician
  • Manahawkin, NJ
  • NPI 1710334727
  Medicare reassignment Care Compare group NPD
• Radiology Affiliates of Central New Jersey PC

  • Diagnostic Radiology Physician
  • Hamilton, NJ
  • NPI 1811994791
  Medicare reassignment Care Compare group NPD
• Trinity Medical Wny PC

  • Internal Medicine Physician
  • Buffalo, NY
  • NPI 1295043149
  Medicare reassignment NPD
• Adi Radiology PC

  • Diagnostic Radiology Physician
  • Franklin, TN
  • NPI 1083266761

  NJ

  Medicare reassignment NPD
• Imaging Associates of Michigan PLLC

  • Diagnostic Radiology Physician
  • Marquette, MI
  • NPI 1164943007

  NJ

  Medicare reassignment NPD
• Imaging Associates of New Mexico LLC

  • Diagnostic Radiology Physician
  • Albuquerque, NM
  • NPI 1629592464

  NJ

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Garnet Health Medical Center

  • General Acute Care Hospital
  • Middletown, NY
  • NPI 1609875772
  Care Compare affiliation
• St. Luke's Cornwall Hospital

  • General Acute Care Hospital
  • Newburgh, NY
  • NPI 1003923434
  Care Compare affiliation
• St. Mary's Healthcare

  • General Acute Care Hospital
  • Amsterdam, NY
  • NPI 1811977796
  Care Compare affiliation
• Vassar Brothers Hospital

  • General Acute Care Hospital
  • Poughkeepsie, NY
  • NPI 1740233899
  Care Compare affiliation
• Vassar Brothers Medical Center

  dba Vassar Diagnostics

  • Clinical Medical Laboratory
  • Poughkeepsie, NY
  • NPI 1780052514

  Hospital

  Care Compare affiliation
• Montclair Hospital LLC

  dba HackensackUMC Mountainside

  • General Acute Care Hospital
  • Montclair, NJ
  • NPI 1982720249
  Care Compare affiliation

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1861856080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 8TH ST APT 3",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073022093",
            "telephone_number": "631-942-9869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 THE PINES",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "115681126",
            "telephone_number": "516-633-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "KENNETH",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-13",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "330543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Dana Bernot, M.D.
• William Raymond Blazey, D.O.
• Felice Bombart, M.D.
• Nancy A Bono, DO
• Evan Boris
• Anna Browne
• Kira Lauren Bryant
• Elizabeth Cavuto
• Heather Chau
• Edward Cho, DO

• Diagnostic Radiology Physician in Old Westbury, NY
• Providers in Old Westbury, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.

Verify at the official NPI Registry.