Kenneth R Dovidio, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

308 Issued in MA

Practice address

555 Turnpike St
Ste 31
North Andover, MA 01845-5923

Phone

(978) 683-4299

Fax

(978) 688-9603

NPI assigned

Mar 23, 2007

Last updated

Oct 7, 2021By 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 MA

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

Specialty

Physician Assistant

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Family Hospital Hospital, Methuen, MA, CCN 220080
• Merrimack Health Lawrence Hospital Hospital, Lawrence, MA, CCN 220010
• Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kenneth.dovidio.1@24138.direct.athenahealth.com

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.

• KD Medicine & Wellness PLLC

  dba KD Medicine & Wellness

  • Physician Assistant
  • North Andover, MA
  • NPI 1669049995
  Medicare reassignment Authorized official
• Todays Wellness PLLC

  • Cardiac Rehabilitation Registered Nurse
  • North Andover, MA
  • NPI 1073380911
  NPD

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

• Lahey Clinic Hospital, Inc.

  • General Acute Care Hospital
  • Burlington, MA
  • NPI 1558392563
  Care Compare affiliation
• Lawrence General Hospital

  dba Merrimack Health Lawrence Hospital

  • General Acute Care Hospital
  • Lawrence, MA
  • NPI 1750381281
  Care Compare affiliation
• LG Newcorp Inc

  dba Merrimack Health Methuen Hospital

  • General Acute Care Hospital
  • Methuen, MA
  • NPI 1265267991
  Care Compare affiliation

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1891812061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 TURNPIKE ST",
            "address_2": "STE 31",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455923",
            "telephone_number": "978-683-4299",
            "fax_number": "978-688-9603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 TURNPIKE ST",
            "address_2": "STE 31",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455923",
            "telephone_number": "978-683-4299",
            "fax_number": "978-688-9603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVIDIO",
        "first_name": "KENNETH",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Stephen Domingos
• Christopher James Donahue, MSW
• Barbara Ann Donovan, RN
• Carla R Dorsey, MS,CCC-SLP
• Lisa Dorval, LICSW
• Scott Joseph Dowd, M.D.
• Dr. David S. Metsch and Associates
• Dr. Emma Wu and Associates
• Linda McGovern Drosdek, MS CCC-SLP
• DRS. Dehpanah, Gharib & Associates

• Physician Assistant in North Andover, MA
• Providers in North Andover, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.